Adjustment Disorder

Adjustment disorders are a group of conditions that can occur when you have difficulty coping with a stressful life event. These can include the death of a loved one, relationship issues, or being fired from work. While everyone encounters stress, some people have trouble handling certain stressors.

The inability to adjust to the stressful event can cause one or more severe psychological symptoms and sometimes even physical symptoms. There are six types of adjustment disorders. Each type is associated with distinct symptoms and signs. Adjustment disorders can affect both adults and children.

Adjustment disorders are treated with therapy, medication, or a combination of both. With help, you can usually recover from an adjustment disorder quickly. The disorder typically doesn’t last more than six months, unless the stressor persists.

The mental and physical symptoms associated with adjustment disorder usually occur during or immediately after you experience a stressful event. While the disorder lasts no longer than six months, your symptoms may continue if the stressor isn’t removed. Some people have just one symptom. Others may experience many symptoms.

The mental symptoms of adjustment disorders can include:

• acting rebellious or impulsive
• acting anxious
• feeling sad, hopeless, or trapped
• crying
• withdrawn attitude
• lack of concentration
• loss of self esteem
• suicidal thoughts

There is one type of adjustment disorder that is associated with physical symptoms as well as psychological ones. These physical symptoms can include:

• insomnia
• muscle twitches or trembling
• fatigue
• body pain or soreness
• indigestion

There are six different types of adjustment disorders. Each type is associated with different symptoms:

1. Adjustment disorder with depressed mood

People diagnosed with this type of adjustment disorder tend to experience feelings of sadness and hopelessness. It’s also associated with crying. You may also find that you no longer enjoy activities that you formerly enjoyed.

2. Adjustment disorder with anxiety

Symptoms associated with adjustment disorder with anxiety include feeling overwhelmed, anxious, and worried. People with this disorder may also have problems with concentration and memory. For children, this diagnosis is usually associated with separation anxiety from parents and loved ones.

3. Adjustment disorder with mixed anxiety and depressed mood

People with this kind of adjustment disorder experience both depression and anxiety.

4. Adjustment disorder with disturbance of conduct

Symptoms of this type of adjustment disorder mainly involve behavioral issues like driving recklessly or starting fights. Teens with this disorder may steal or vandalize property. They might also start missing school. 

5. Adjustment disorder with mixed disturbance of emotions and conduct

Symptoms linked to this type of adjustment disorder include depression, anxiety, and behavioral problems.

6. Adjustment disorder unspecified

Those diagnosed with adjustment disorder unspecified have symptoms that aren’t associated with the other types of adjustment disorder. These often include physical symptoms or problems with friends, family, work, or school.

A variety of stressful events can cause an adjustment disorder. Some common causes in adults include:

• death of family member or friend
• relationship issues or divorce
• major life changes
• illness or health issue (in you or someone you’re close with)
• moving to a new house or place
• sudden disasters
• money troubles or fears

Typical causes in children and teenagers include:

• family fights or problems
• problems in school
• anxiety over sexuality

Anyone can develop an adjustment disorder. There isn’t any way to tell who out of a group of people experiencing the same stressor will develop an adjustment disorder. Your social skills and methods for coping with other stressors may determine whether or not you develop an adjustment disorder.

In order to be diagnosed with an adjustment disorder, you 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 are not the result of another diagnosis

If you are diagnosed with an adjustment disorder, 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 can help you return to a regular level of functioning. Therapists offer you their emotional support and can help you understand the cause of your adjustment disorder. This together can 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 (focuses on solving problems by changing unproductive thinking and behaviors)
• interpersonal psychotherapy, or IPT (short-term psychotherapy treatment)

Medication

Some people with adjustment disorders also benefit from taking medications. Medications are used to lessen some of the symptoms of adjustment disorders, such as insomnia, depression, and anxiety. These medications include:

• benzodiazepines (such as lorazepam and alprazolam)
• nonbenzodiazepine anxiolytic (such as gabapentin)
• SSRI or SNRI (such as sertraline or venlafaxine)

The outlook for recovering from an adjustment disorder is good if you are treated quickly and correctly. You should recover quickly. The disorder doesn’t usually last more than six months in most people.

• developing a strong network of people to support you
• looking for the positive or humor in hard situations
• living healthfully
• establishing good self-esteem

It can be helpful to prepare for a stressful situation if you know you will need to confront it in advance. Thinking positively can help. You can also call your doctor or therapist to discuss how you can best manage especially stressful situations.