Adjustment Disorder: Navigating Anxiety and Treatment - Psychiatry

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Adjustment disorder, or "適應障礙," is a psychological condition that arises when an individual struggles to cope with a significant life change or stressor. This can manifest as anxiety, depression, or a combination of both, often leading to emotional distress and difficulty functioning in daily life. Your description of experiencing rapid heart rate, feelings of tension, and self-harm tendencies suggests that you are grappling with significant anxiety and emotional turmoil, which is common in adjustment disorders.

The medications you mentioned—Luvox (fluvoxamine) and a sleep aid—are often prescribed to help manage symptoms of anxiety and depression. Luvox is a selective serotonin reuptake inhibitor (SSRI) that is effective in treating obsessive-compulsive disorder (OCD) and anxiety disorders. It works by increasing serotonin levels in the brain, which can help improve mood and reduce anxiety. The sleep aid is likely intended to help you achieve better sleep quality, which is crucial for mental health.

It's important to recognize that while medication can be beneficial, it may not address all aspects of your condition. The feelings of instability and anxiety you experience when faced with stressors suggest that additional therapeutic support could be beneficial. Cognitive-behavioral therapy (CBT) is a common and effective treatment for adjustment disorders, as it helps individuals develop coping strategies and address negative thought patterns.

Your concerns about your doctor's perception of your condition are valid. It's not uncommon for patients to feel misunderstood or dismissed, especially when their internal experiences don't seem to align with external assessments. It's crucial to communicate openly with your healthcare provider about your feelings and experiences. If you feel that your doctor is not adequately addressing your concerns, consider seeking a second opinion or finding a therapist who specializes in anxiety and adjustment disorders.

The feelings of relief you experience when away from work indicate that your job may be a significant source of stress. It’s essential to evaluate whether your work environment is contributing to your anxiety and whether adjustments can be made to alleviate some of that pressure. Sometimes, even minor changes in workload or responsibilities can lead to significant improvements in mental health.

Your mother's comments about your doctor's encouragement may also be influencing your perception of your situation. While it's important to have supportive feedback, it’s equally essential for you to feel validated in your struggles. If you believe that your experiences are not being taken seriously, it might be helpful to express this to your doctor. A good clinician will appreciate your honesty and work with you to ensure that your treatment plan is tailored to your needs.

In summary, adjustment disorder can be challenging, but with the right combination of medication, therapy, and support, many individuals find relief from their symptoms. It's crucial to advocate for yourself in your treatment journey, ensuring that your concerns are heard and addressed. If you continue to feel that your needs are not being met, consider seeking additional support from a mental health professional who can provide a more comprehensive approach to your care. Remember, recovery is a process, and it's okay to seek help along the way.