309.28 Adjustment Disorder with Mixed Anxiety and Depressed Mood (Chronic)

The diagnostic criteria in the DSM-IV are:

A. The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within three months of the onset of the stressor(s).

B. These symptoms or behaviors are clinically significant as evidenced by either of the following:

1. marked distress that is in excess of what would be expected from exposure to the stressor

2. significant impairment in social or occupational (academic) functioning

C. The stress-related disturbance does not meet the criteria for another specific Axis I disorder and is not merely an exacerbation of a preexisting Axis I or Axis II disorder.

D. The symptoms do not represent Bereavement.

E. Once the stressor (or its consequences) has terminated, the symptoms do not persist for more than an additional six months.

Originally, I thought my diagnosis might include: Adjustment Disorder with Mixed Depressive and Anxiety symptoms. However, I don't think the depression or anxiety I experienced were in excess of what would be expected from exposure to the stressor(s in my case), there was no impairment in my academic functioning (I was the top student), I had a few friends, and an eating disorder would seem to be the primary diagnosis.

Puberty is a time when many struggle, and it could be that the combination of puberty and certain other life events pushed my symptoms over the line from manageable to increasingly unmanageable. Throughout my teens, there were what seemed like almost constant upheavals. I barely had time to adjust to one change or a series of changes before more occurred.

In the three years before high school started, I moved three times and attended three different schools - and these moves included moving very far from not only our father, but from other family members and people we had known for about three years. Northern Ontario is considerably different to Southern Ontario. During this time, my grandmother died, which resulted in extreme grief for me, and in addition, a beloved pet of mine disappeared. When I started high school, there was a dramatic and possibly traumatic incident in which the police were sent by my mother to my father's - lights flashing and sirens blaring, and then I was questioned about the situation, and had to prove that I was legally old enough to make the choice to live with my father. Many angry phone calls from my mother followed, in which she told me I was throwing my life away. And in addition, I had had my hopes up regarding an appointment with a dermatologist, but there was (and is) no cure for ichthyosis.

My eating problems might have signified some trouble with adjusting, but for my age, I was in fact dealing with a lot of stress. I remained a top student for my first two years of high school, and although not popular, I did feel accepted by a few groups in a social sense. Although I was experiencing distress in private, outwardly I was coming across as high-functioning.