Adjustment Disorder May Be the “New” Personality Disorder

August 16, 2010 By
Posted in Spouse and Family

According to an article on Army News Online the “Adjustment Disorders”  increased 164% last year. This increase come on the tail of a dramatic decrease in personality disorder (PD) diagnoses after complaints have been filed alleging this diagnosis was used to discharge qualifying Veterans in a way that was sure to strip them of their benefits.

Things that make you go “hm?”  Is this a mere coincidence, or is AD the new PD?

I am not sure how adjustment disorder (AD) is diagnosed in the military, but it is obviously not subject to the same rules as AD in the civilian world. There are time constraints and other situational factors around giving this diagnosis. For example, a person has to show a negative response to a change within 3-month of it’s occurrence. I am willing to go out on a limb and say most (not all) with true AD will show symptoms much faster due to the intensity of change in BCT/AIT. The change in behavior must be extreme and in direct response to the change and not to other things. The amount of reaction to the change must be in a direct proportion to the behavior exhibited as well. So, a soldier who is agitated when he first entered a war zone is not having adjustment disorder. This is normal. A soldier  who is depressed  after coming home from witnessing a lot of combat and losing a lot of friends is not abnormal. His grief, stress and trauma response are no indicator that he can not adjust.

I just don’t see how either of these diagnoses can be placed on anyone after combat and especially after a PTSD diagnosis. If the Army wants to kick people out they need to beef up their testing and get them out before deployment. After deployment things are way too muddled… and besides my take on this has been if soldiers serve well and face deployments then give them the benefits they have earned! No diagnosis can negate the fact that a soldier followed orders and did his job.

Below is an excerpt from a couple of parts of the article I read. What are your takes on this? I’m not saying that no soldier should ever get this diagnosis and discharge… I am concerned greatly about the sharp increase:

Discharges for adjustment disorder soar
By Kelly Kennedy – Staff writer
Posted : Saturday Aug 14, 2010 12:34:17 EDT

Two years ago, under congressional pressure, the military changed its policy on separating troops dealing with combat stress for pre-existing personality disorders — an administrative discharge that left those veterans without medical care or other benefits.

Now, veterans advocates say, the personality-disorder discharges have been replaced with similar discharges for “adjustment disorder.” And once again, Congress seems poised to jump in.

Sen. Christopher “Kit” Bond, R-Mo., plans to send a letter to President Obama asking that the military provide detailed data showing how many people have been discharged for adjustment disorders. In the meantime, Bond’s staff has been gathering more general data that shows discharges for “other designated physical or mental conditions not amounting to disability” — a broad category that includes adjustment disorder — have increased from 1,453 in 2006 to 3,844 last year, an increase of 165 percent.

Over the same time, discharges for personality disorder dropped from 1,072 in 2006 to 260 last year.

“We request your assistance to ensure that a new loophole has not been created that abuses the administrative discharge system by erroneously discharging members of the armed forces who are experiencing symptoms of PTSD and/or TBI, rather than providing them with compassionate medical care worthy of their service and sacrifice,” states a draft copy of Bond’s letter.

SNIP

‘TOOLS TO SELF-DESTRUCT’
During his 2008 deployment to Iraq, Army Pfc. Michael Nahas, 22, said he lived through two roadside bomb explosions and one rocket-propelled grenade attack, and watched people die in another explosion in Mosul, where he served with the 4th Infantry Division.

Two months after he returned home to Fort Carson, Colo., he said he began feeling anxious and guilty about people who he believed had died needlessly.

He went to the post mental health clinic for help. Over the course of three weeks, he had three appointments — and a lot of medication, including 14 milligrams of Xanax a day, he said.

“I was drooling on myself,” he said. “I could barely function.”

His mother and veterans’ advocates verified his doses.

After enlisted supervisors in his chain of command found out he was going to behavioral health, Nahas said they made fun of him, including calling him “crazy” and telling him daily to kill himself so he’d no longer be a problem to the unit.

A division spokesman declined to address Nahas’s account in detail.

“The allegations made by Mr. Nahas were thoroughly investigated,” said Army Lt. Col. Steve Wollman. “Some of the allegations were unsubstantiated and some of them were substantiated. Appropriate corrective actions were made and the investigation is closed. Due to the nature of individual cases we do not talk specifics out of respect for the privacy of the soldier.”

Nahas said the stress and a subsequent reaction to his medication led him to attempt suicide in February by jabbing IV needles into his arms to bleed out.

“I tried to kill myself,” he said. “I was so out of it I was drawing pictures on the wall with my own blood.”

In a photo of the aftermath provided by his family, blood fills a bathtub and a red smiley face gazes down from the tile.

His wife found him curled up on the floor and called for help, and Nahas survived.

After his suicide attempt, he spent time in an inpatient clinic where he was diagnosed with PTSD, and then went back to his unit. But rather than beginning the medical evaluation and retirement process for PTSD, his battalion chain of command gave him an administrative discharge for adjustment disorder at the end of April, and sent him back to civilian life.

“I don’t understand it,” Nahas said. “I was told I had PTSD, and then I was told I didn’t. I always tried — I was a good soldier. I mean, they told me that.”

LINK TO ENTIRE ARTICLE

5 Responses to Adjustment Disorder May Be the “New” Personality Disorder

  1. Pingback: Tweets that mention Adjustment Disorder May Be the “New” Personality Disorder -- Topsy.com

  2. Adjustment Disorders became payable by the VA on 11-7-96. Personality Disorders are not payable, never were, never will be. So my advice to recently dischrged veterans, apply for Adj DO and while you are waiting for your C and P exam, see a psych regularly so he writes down and considers that your AD is chronic as that is what the VA will be looking for. I got discharged 27 years ago with the dreaded Pers DO and am still fighting the VA. If I had been discharged with Adj DO, I would have been being paid for the last 27 years. Go for it!

  3. Karl C. Rankin Jr.

    Sir,
    I was discharged in 1988 for a personality disorder after serving 4 years honorably at the 101st airborne. I re-enlisted for 6 years and then discharged. I received no medical treatment and was homeless for the most part til now. I lived on the streets in S.L.C., Ut., Wyoming, Florida, Montana, Ky., Tenn. Nevada, Colorado. etc. When I became despondant qnd a threat to myself and others 4 years ago, I sought help in Sheridan, Wyo. Gave some anti-depressants and discharged. Last year, here in Ky. at 58 I again became suicidal and sought help at the VA. I’m seeing a a doctor and getting care thru the per diem program. If that wasn’t availaible likely… . Severe alcoholism and drug abuse since discharge. Now, they say after filing for diability, I won’t get it. It doesn’t go away. The disorder. Karl

  4. Karl, nearly every person on disability is denied their first try, and sometimes their second too. My advice is to contact your local congressman (only if you know he/she is sympathetic toward Veterans) and let him/her know you are filing. They can help the process along. Even if it means you are denied faster that means you can appeal it faster and keep it moving. It can take a long time to establish it, but it sounds like you should qualify just on the basis of your long term mental health issues. Don’t give up on it! Remember that if you continue to appeal your disability will become retroactive to when you first applied, so don’t drop the ball and let if fall to the wayside. :)

  5. Currently serving OCONUS, recently PCSing from the states .. I take non addictive and non narcotic medication to help with “adjustment disorder.” Within the past week i just found out that I was diagnosed and have been for almost a year. The term is new to me so i started reseaching it. I didn’t know that some of these disorders could affect my benefits in the long run. And now it’s like i’m at a stopping point again, after reading up on it. I fought SO hard within myself to seek help with my issues after deployment.. it almost took me to the point that i had to lose everything before i gave in, regardless of my pride or people looking down upon me, as if i’m weak.
    But, im at a new unit now… and ofcourse i still have issues. wha brought it up is that i ran out of my meds… and have to go through this system all over again, which i’m fine with… but i’m just stuck.. because the army publicly says that we want soilders to get help…. but at unit level, you are looked at as weak….. which in most cases i can handle. but now to find out that it may affect my benefits. It’s like i’d rather just stop with the appointments just so i don’t risk any chance of discharge or my benefits.

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