Adjustment Disorders

Symptoms

Signs and symptoms depend on the type of adjustment disorder and can vary from person to person. You experience more stress than would normally be expected in response to a stressful event, and the stress causes significant problems in your life.

Adjustment disorders affect how you feel and think about yourself and the world and may also affect your actions or behavior. Some examples include:

  • Feeling sad, hopeless or not enjoying things you used to enjoy
  • Frequent crying
  • Worrying or feeling anxious, nervous, jittery or stressed out
  • Trouble sleeping
  • Lack of appetite
  • Difficulty concentrating
  • Feeling overwhelmed
  • Difficulty functioning in daily activities
  • Withdrawing from social supports
  • Avoiding important things such as going to work or paying bills
  • Suicidal thoughts or behavior

Symptoms of an adjustment disorder start within three months of a stressful event and last no longer than 6 months after the end of the stressful event. However, persistent or chronic adjustment disorders can continue for more than 6 months, especially if the stressor is ongoing, such as unemployment.

Causes

Adjustment disorders are caused by significant changes or stressors in your life. Genetics, your life experiences, and your temperament may increase your likelihood of developing an adjustment disorder.

Risk factors

Some things may make you more likely to have an adjustment disorder.

Stressful events

Stressful life events — both positive and negative — may put you at risk of developing an adjustment disorder. For example:

  • Divorce or marital problems
  • Relationship or interpersonal problems
  • Changes in the situation, such as retirement, having a baby, or going away to school
  • Adverse situations, such as losing a job, loss of a loved one, or having financial issues
  • Problems in school or at work
  • Life-threatening experiences, such as physical assault, combat, or natural disaster
  • Ongoing stressors, such as having a medical illness or living in a crime-ridden neighborhood

Your life experiences

Life experiences can impact how you cope with stress. For example, your risk of developing an adjustment disorder may be increased if you:

  • Experienced significant stress in childhood
  • Have other mental health problems
  • Have a number of difficult life circumstances happening at the same time

How is adjustment disorder diagnosed?

In order to be diagnosed with an adjustment disorder, a person must meet the following criteria:

  • experiencing psychological or behavioral symptoms within three months of an identifiable stressor or stressors occurring in your life
  • having more stress than would be ordinary in response to a specific stressor, or stress that causes issues with relationships, in school or at work, or experiencing both of these criteria
  • the improvement of symptoms within six months after the stressor or stressors are removed
  • symptoms that aren’t the result of another diagnosis

How is adjustment disorder treated?

If you receive an adjustment disorder diagnosis, you would probably benefit from treatment. You may require only short-term treatment or may need to be treated over an extended period of time. Adjustment disorder is typically treated with therapy, medications, or a combination of both.

Therapy

Therapy is the primary treatment for an adjustment disorder. Your doctor or healthcare provider may recommend you see a mental health professional. You may be referred to a psychologist or mental health counselor. However, if your doctor thinks that your condition requires medication, they may refer you to a psychiatrist or psychiatric nurse practitioner.

Going to therapy may enable you to return to a regular level of functioning. Therapists offer you their emotional support and can assist you in understand the cause of your adjustment disorder. This may help you develop skills to cope with future stressful situations.

There are several kinds of therapies used to treat adjustment disorders. These therapies include:

  • psychotherapy (also called counseling or talk therapy)
  • crisis intervention (emergency psychological care)
  • family and group therapies
  • support groups specific to the cause of the adjustment disorder
  • cognitive behavioral therapy, or CBT (which focuses on solving problems by changing unproductive thinking and behaviors)
  • interpersonal psychotherapy, or IPT (short-term psychotherapy treatment)