What is adjustment disorder? Everything you need to know

Adjustment disorder is a condition some people may experience in the months following a stressful event or a change in life.

Adjustment disorder can cause a variety of symptoms including depression , anxiety, and emotional disturbance.

Doctors may diagnose depression , anxiety or a mixed depression and anxiety adjustment disorder.

Many people can also refer to situational depression as adjustment disorder. They ‘re not the same circumstances, however.

In this article we discuss the causes and symptoms of adjustment disorder, as well as the options for diagnosis and treatment.

What it is

A lady having adjustment disorder
Life changes, such as moving house, may cause adjustment disorder.

Adjustment disorder is an severe emotional or behavioral reaction within three months following a stressful or monumental event in life.

In response to a given situation, people can experience an abnormal reaction or a higher level of emotional disturbance than expected. This stress can trigger a variety of symptoms that could psychologically and physically affect people.

Adjusting disorder signs are not related to any mental health problem, or through the normal phase of grieving or adjusting to a dramatic change in life.

Also positive events that are major changes may cause adjustment disorder.

Examples of life events or changes that could cause adjustment disorder include:

  • moving home
  • divorce or separation
  • the loss of a loved one
  • the birth of a child or sibling
  • a serious illness or severe injury
  • moving to a new school
  • marital difficulties
  • retirement
  • financial difficulties
  • losing a job
  • a natural disaster or traumatic event

Some factors can increase the chances of people suffering from an adjustment disorder.

Genetics, life experience, personality and mental health problems can all play a role in how people respond to events in life.

This can worsen if people encounter several stressors at once to cause adjustment disorder.

Children with regular stress have a higher risk of having an adjustment disorder.

Adjustment disorders occurs similarly in males as well as females.

Adjustment disorders begin within 3 months of a stressful event and do not continue for more than 6 months after the incident, and the effects have stopped.

However, chronic adjustment disorder will last longer than this time period in some cases.

Symptoms

Symptoms of adjustment disorder can include:

  • depressed mood
  • frequent worrying or feeling anxious
  • frequently feeling tearful or crying
  • hopelessness
  • feeling jittery and nervous
  • reckless behavior or breaking of societal rules
  • social withdrawal
  • suicidal thoughts or behaviors
  • difficulty functioning as usual in school, college, or work

People may only have emotional symptoms, while others may only have behavioral symptoms.

Suicide prevention

If you know someone at urgent risk of self-harm, suicide, or harming another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you have thoughts of suicide, or someone you know, a hotline for prevention will help. The National Lifeline for Suicide Prevention is available at 1-800-273-8255 24 hours a day. People with trouble hearing should dial 1-800-799-4889 during a crisis.

Click here for more links and local resources.

Types

There are six different types of adjustment disorders, which doctors base on the main accompanying symptoms.

People can have the following types of adjustment disorder:

  • With anxiety: Feeling nervous, worried, jittery, or having a fear of separation.
  • With depressed mood: Feeling depressed, hopeless, or tearful.
  • With anxiety and depressed mood: A combination of the above symptoms.
  • With disturbance of conduct: Violating the rights of others, violating societal norms and rules.
  • With disturbance of emotions and conduct: A combination of all the above types of adjustment disorder.
  • Unspecified: Symptoms that do not fit into any of the above categories.

Symptoms in children

Symptoms of an adjustment disorder may vary according to the individual’s age.

Children and teenagers may have more symptoms of behavior , for example aggressive behaviour. More depressive symptoms can develop in adults.

In particular, children may suffer the following symptoms:

  • trouble sleeping
  • frequent crying
  • avoiding or not wanting to go to school
  • isolating themselves from friends and family
  • picking fights
  • irritability
  • vandalism
  • showing hostility
  • depression and anxiety

Differences from PTSD, depression, and anxiety

People with an adjustment disorder can experience a group of symptoms that correlate with other conditions:

These include:

  • post-traumatic stress disorder (PTSD)
  • depression
  • anxiety

People can experience a depressed mood and anxiety with adjustment disorder.

Adjustment disorder has a different set of criteria than other mental health disorders, however, which helps clinicians to differentiate between them.

PTSD typically occurs during a life-threatening event, including war or physical attack, opposed to a life-change or stressor that may cause adjustment disorder. Also, PTSD can last longer than adjustment disorder.

Complex PTSD can occur when a person has undergone prolonged or repeated trauma, rather than just one event.

It can be difficult to separate adjustment disorder from depressive disorders, as they can share similar symptoms.

Doctors may use an instrument called Diagnostic and Statistical Manual of Mental Disorders (DSM–5), which lists criteria for mental health disorders. Adjustment disorder also appears in the international medical classification list known as the ICD-10.

Doctors may use these guides to test whether the symptoms of a individual match the adjustment disorder requirements, rather than another mental health condition.

Diagnosis

A doctor may examine a person’s symptoms, ask about their medical background, and perform a clinical examination to identify a condition of adjustment. The test aims to rule out any other mental health problems.

A doctor may interview individuals about any recent events that may have caused adjustment disorder. They will also look at the personal history of emotional and behavioral patterns in an individual.

Doctors may check in children if development is as they expect it to be, as this can affect emotional and behavioral response.

A doctor may use the DSM-5 to test whether the symptoms fit the adjustment disorder criteria, rather than another mental illness.

In certain cases, blood and urine tests may be prescribed to ensure that the symptoms don’t come from another disease.

Treatment

Psychotherapy can help people overcome adjustment disorder, or talk therapy.

A person can meet with a psychotherapist regularly to work through the disorder’s emotional and mental symptoms. Others may find group therapy useful in redeveloping interpersonal and social skills.

One approach may include cognitive behavior therapy (CBT). This technique focuses on changing patterns of thought to help people solve problems and develop positive methods of coping with them.

The family therapy can benefit children or family members with an adjustment disorder.

Family members will work with a therapist to bring about positive changes, such as improved communication, interactions and greater family support.

In some cases a doctor may prescribe medication for symptoms such as depression and anxiety alongside treatment with psychotherapy. However, medications are usually not the first line of treatment in adjustment disorders.

Summary

Adjustment disorder is an extreme response to a stressful event or significant change in life. It can affect persons of any age. Changes in family structures, divorce or move can all trigger a disorder of adjustment.

People may experience depression, anxiety or hopelessness. We can socially withdraw, feel more tearful than normal, or be having trouble sleeping.

In particular, children and teenagers may exhibit disruptive behavior.

Adjustment disorder occurs within 3 months of a stressful event, and typically does not last longer than 6 months after the event, and its consequences resolve.

If people have signs of adjustment disorder, they should see their doctor. A doctor, such as a psychotherapist, may refer them to a mental health professional. Talking therapies can help someone conquer the adjustment disorder.

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