Adoption Stress

Adoption Stress

Unfortunately, far too many adoptive children have faced traumatic events including, but not limited to, neglect, physical and sexual abuse and various degrees of abandonment. In recent months, I have accompanied Dr. George Rogu on a speaking tour with AdoptionDoctors.com. As the “Adoption Psychologist,” I regularly explain to adoptive parents that by having an understanding of the symptoms suggestive of traumatic exposure, we can identify children who may be experiencing traumatic stress reactions. Ultimately, by identifying symptoms early, we can address emotional, social, behavioral and educational needs. As I often say to parents, we certainly don’t wait to address physical trauma. And, in the same way, we must not wait to address traumatic stress.

How is traumatic stress manifested in adoptive children?

In the young adopted child, we see immature and regressive behaviors—behaviors that have been abandoned in the past are often observed again (e.g., thumb sucking, bed wetting, fear of the dark, loss of bladder control, speech difficulties, decreases in appetite, clinging and whining, and separation difficulties). Older children may manifest periods of sadness and crying, poor concentration, fears of personal harm, aggressive behaviors, withdrawal/social isolation, attention-seeking behavior, anxiety and fears, etc.

So, what is “Adoption Stress”? Does it refer solely to the experience of so many adoptive children?

The reality is, when we look closely at adoption, we realize that traumatic stress is pervasive - often impacting several, if not all, of the parties involved. Unfortunately, this traumatic stress, “adoption stress,” is generally not recognized and its impact is misunderstood. Consider the following….
Birth parents, who surrender a child for adoption, typically experience a great deal of stress. Oftentimes, due to their circumstance, they have little choice or control and must surrender their child for adoption.

Adoptive parents often bring to the table a history of stress. For example, pre-adoption stressors, which may include fertility problems, losses and significant relationship conflicts. There is also stress associated with the acquisition of an adoptive child. For example, there may be serious medical concerns, “misunderstandings,” and heartbreaking disappointments. Finally, post-adoption stress may center around the realization of a dream, tremendous life changes with new responsibilities, and a future marked by uncertainty and fear.

Adoption stress is manifested in the feelings, thoughts, actions and physical reactions of all parties associated with the adoption process—by birth parents, adoptive parents and certainly, adoptive children. By understanding adoption stress and recognizing the symptoms, we can intervene early, educate and empower victims, and prevent acute difficulties from becoming chronic problems.

Dr. Mark Lerner is a Clinical Psychologist and Traumatic Stress Consultant who focuses on helping people during and in the aftermath of traumatic events. He is the President of the American Academy of Experts in Traumatic Stress (www.aaets.org) and the originator of the Acute Traumatic Stress Management intervention model (www.atsm.org). Dr. Lerner wrote and produced the newly released audio book, Surviving and Thriving: Living Through a Traumatic Experience (www.DrMarkLerner.com). He is the Editor and Publisher of Trauma Response, the Academy’s official publication, and the author of five books. Dr. Lerner consults regularly with individuals, schools and organizations—where he specializes in the education, training and implementation of Acute Traumatic Stress Management and the development of organizational and school-based crisis management teams. Dr. Lerner has conducted numerous interviews, including CNN Headline News, the Los Angeles Times, Newsweek, Self Magazine, Stars & Stripes, Reuters, the Associated Press and U.S. News & World Report. Most recently, he appeared on Dateline NBC. Dr. Lerner lives in New York with his wife and three children.

Post Adoption Depression

The term "Post-Adoption Depression" has been used to explain the feelings of sadness that are experienced by many adoptive parents subsequent to the adoptive process. Unlike postpartum depression, which may be caused by significant physiological and hormonal changes (e.g., a sudden decrease in estrogen and progesterone in the bloodstream), Post-Adoption Depression cannot. Post-Adoption Depression focuses on the feelings of sadness that are experienced after the attainment of a long-term goal that has required time, money, effort, emotional strain and patience.

New York Post-Adoption Depression is a symptom that falls under a much larger umbrella - what I have called "Adoption Stress." The latter refers to the feelings, thoughts, actions and the physical and spiritual reactions of all parties who are involved in the adoption process (e.g., a mother who surrenders her child for adoption, an adoptive child, an adoptive parent, a compassionate case worker, etc.).

We can better understand and appreciate the depressive symptomatology experienced by many adoptive parents if we first consider 1) pre-adoption stressors, 2) stress associated with the acquisition of an adoptive child and 3) post-adoption stress. By focusing solely on Post-Adoption Depression, we miss the causative or related stressors that contribute to the adoptive parent’s feelings of sadness. For example, the attainment of a long-term goal of having an adoptive child often opens the door to seemingly insensitive questions from others about infertility and prior losses. These questions will likely stimulate unresolved feelings, and may cause adoptive parents to revisit pre-adoption stress. The acquisition of an adoptive child is often colored by serious medical concerns, "misunderstandings" and heartbreaking disappointments. And, the post-adoption experience is often marked by tremendous life changes, new responsibilities and a future marked by uncertainty and fear.

During a recent therapeutic session with a group of adoptive parents, we explored a number of participants’ feelings of sadness. Suddenly, one mother exclaimed, "I didn't sign-up for this!" Her comment was met by applause from several of the participants. Her statement underscores the complex continuum of "before, during and after stressors" that are faced by adoptive parents.

How can we prevent Post-Adoption Depression? First, we must educate all people involved in the adoptive process about Adoption Stress. If more people understood that the feelings, thoughts, actions and the physical and spiritual reactions were a normal response to a very stressful, multifaceted experience, fewer people would struggle with conflicted feelings. We must also focus our attention on parents who have been prone to feelings of depression and do not fare well when faced with considerable stress. We must encourage them to become involved in support groups or counseling. If we do this prior to parents entering into the adoptive process we can ultimately decrease the post-adoption stress that is experienced by many adoptive parents.

Written By Mark Lerner, Ph.D.

Depression in men less frequent than women

Depression occurs in the young and the old and in men and women. We do know that the rate of depression in men is less than for women.

The symptoms that men experience can be different from those that women experience. Symptoms including anger, irritability, and feeling discouraged are more common in men than symptoms of hopelessness or helplessness.

Typical symptoms we associate with depression such as depressed mood may not be present in depression in men. This can make it more difficult to recognize depression in men. Many famous men, including President Abraham Lincoln and Winston Churchill, had depression and still lived successful lives.

Unfortunately, men are not as likely as women to admit to having depression. Even if they do admit to having depression, they may be less likely to seek treatment. Men may stuff their feelings instead of verbalizing them. They may work more, gamble, or use alcohol or drugs to avoid their feelings. Their sleep and or appetite may change. They may suddenly begin talking about divorce or separation.

Women attempt suicide more often than men, but the rate of completed suicide in men is 4 times that of women. Suicide rates peak in mid life and again later in life. Men age 85 and older have the highest suicide rate.

Men want and need to be strong for their families; they don't want to appear weak or vulnerable. If they are the primary bread winner, they can feel pressure to provide for their dependents. Of course, these general statements can be applied to women as well.
Depression in men is treatable. If you suspect a friend or loved one may be depressed, urge them to seek a professional evaluation. There are many options, including medication, therapy or a combination of the two.

By Gabrielle J. Melin, M.D.