What Is Adjustment Disorder?

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Major life changes, such as the death of a loved one or moving to a new city, can cause stress. Most people adjust to these changes within a few months.

For some, however, coping with the stress that comes with these changes can be so overwhelming that it disrupts their lives.

When these feelings persist longer than usual, it may be a sign of an adjustment disorder.

Adjustment Disorder Symptoms

An adjustment disorder is categorized according to the type of reaction it causes. There are six subtypes of adjustment disorder listed in the DSM-5. Each is based on the type of major symptoms experienced. 

  • Adjustment disorder with depressed mood: Low mood, tearfulness, and feelings of hopelessness.
  • Adjustment disorder with anxiety: Nervousness, worry, jitteriness, and fear of separation from caregivers.
  • Adjustment disorder with mixed anxiety and depressed mood: A combination of the above symptoms.
  • Adjustment disorder with disturbance of conduct: Violating the rights of others, violating societal norms and rules.
  • Adjustment disorder with mixed disturbance of emotions and conduct: A combination of symptoms from all of the above subtypes are present (depressed mood, anxiety, and conduct).
  • Adjustment disorder unspecified: Reactions to stressful events don’t fit any of the above subtypes. Reactions may include behaviors like social withdrawal.

Symptoms may vary according to the age of the person experiencing the condition. Children and teens are more likely to display behavioral symptoms, such as school problems or acting out. Adults, on the other hand, tend to experience more emotional symptoms. 

Causes

Experts have not identified a specific cause for why a person might struggle with adjustment disorder, but there are certain factors that can increase your risk for developing this condition.

Adjustment disorders can happen at any age, but they are especially common in children. Any stressful event or series of situations can trigger this condition. Common stressors for adults include:

  • Death of a loved one
  • Divorce or relationship problems
  • Financial difficulties
  • Getting married
  • Having a baby
  • Illness or other health issues in yourself or a loved one
  • Living in a high crime neighborhood
  • Loss of employment
  • Moving to a new place
  • Natural disaster
  • Retirement

Some stressors that may lead to adjustment disorder in children and teens include:

  • A new brother or sister
  • Death of a pet
  • Parental divorce or separation
  • Entering a new school or leaving school
  • Leaving home for the first time
  • Sexuality issues (such as uncertainties related to sexual orientation)

As you can see, a stressor can be a single event (termination of a relationship) or multiple events (relationship problems), that can be continuous (living in an unsafe community) or recurrent (seeing your ex during the holidays). 

Diagnosis

The diagnosis of an adjustment disorder is typically made by a mental health professional, (such as a psychologist or psychiatrist) after performing a full psychological evaluation. The evaluation includes a detailed personal history of development, life events, emotions, behaviors, and the identified stressful event.

To be diagnosed with an adjustment disorder, your symptoms must be “clinically significant.” According DSM-5, this means that you must meet one or both of the following criteria:

  • Your distress is out of proportion with the expected reaction
  • Your symptoms must significantly impair your personal life, social functioning, or work/school performance and/or attendance. 

Additionally, to be diagnosed:

  • Your symptoms must have begun to appear within three months of the stressor occurring.
  • Your distress and impairment don’t meet the criteria for another disorder (such as post-traumatic stress disorder or PTSD) and are not the result of an existing mental health disorder.
  • Your reaction is not part of normal bereavement.
  • When the stressor is removed, your symptoms subside within six months.

Adjustment disorder is often difficult to diagnose because it shares symptoms with other mental health disorders

Adjustment Disorder Treatment

The main goal of treatment is to relieve symptoms and help you return to a similar level of functioning as before the stressful event occurred.

Psychotherapy

Adjustment disorder is highly treatable and often responds well to psychotherapy. Regardless of the stressor, therapy will help you understand how and why the stressor has affected your life. Therapy will also help you develop better coping skills and stress management to deal with stressful events.

The form of psychotherapy will vary from patient to patient. Because of the brevity of adjustment disorders, short-term psychotherapy, like cognitive behavioral therapy (CBT), is generally preferred. 

Some people may also benefit from family therapy, especially if the situation is family-related or the patient is an adolescent. Couples therapy may be ideal if the disorder is negatively impacting a romantic relationship.

Medication

Although psychotherapy is the first-line treatment for adjustment disorder, medications are sometimes prescribed to alleviate troublesome symptoms, such as anxiety, depression, and insomnia.

Coping

Here are a few tips to keep in mind when coping with an adjustment disorder.

  • Avoid unnecessary stress. Stress is sometimes unavoidable. Though you may not have the power to avoid all stressful situations, anything you can do to reduce your stress is helpful. For instance, if you have a big change coming up in your life, don’t take on additional responsibilities that will make you even more anxious. 
  • Join a support group. Sometimes it helps to share your anxieties with people who have been through a similar situation. There are a variety of stressors that are addressed in support groups, from divorce to loss of a loved one
  • Lean on your support system. Having someone you trust that to listen without judgment or shaming is invaluable during times of stress. Tell friends and family you’re feeling overwhelmed, and let them know how they can help you.

A Word From Verywell

Everybody experiences stress from time to time, but some situations can be more difficult to handle than others. If you recently experienced an upsetting event and the stress is interfering with your daily life, talk to your doctor or contact a mental health professional as soon as possible. It is the first step in getting you back on track and enjoying life to the fullest.

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