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Adjustment Disorder
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Anxiety Defined: Adjustment Disorder 1:23
Adjustment disorder is a strong emotional or behavioral response to a stressful event or major life change. This might include a breakup, moving, financial challenges, a new medical diagnosis, or losing someone important. These symptoms are usually short term, but they can last longer if the stress continues or feels hard to manage.
Symptoms include feeling sad, worried, or hopeless; acting impulsively; having trouble focusing; changes in sleep; feeling tense or easily upset; or having physical symptoms like headaches or a racing heartbeat. Some people withdraw from friends or activities because everything feels overwhelming.
It develops after a difficult event or major life shift. Sometimes several stressors happen at once, which makes the reaction stronger. Having fewer coping skills, limited support, or a history of anxiety or depression can also make someone more likely to experience adjustment disorder.
A healthcare provider will ask about symptoms, daily stressors, and any recent life changes. They may do a physical exam or refer the person to a mental health professional. A diagnosis is made when symptoms begin within three months of the stressful event and cause noticeable problems at home, school, work, or in relationships.
Adjustment disorder itself isn’t directly inherited, but genetics can affect how someone responds to stress. If a family member has anxiety or depression, a person may be more sensitive to stressful situations.
For many, symptoms improve as the situation becomes more manageable or as they adjust to the change. Most symptoms lessen within six months after the stressor ends. Still, treatment can help someone feel better faster or offer support if symptoms feel intense.
Therapy, especially cognitive behavioral therapy (CBT), can help someone build coping skills, understand their reactions, and manage stress more effectively. Support groups or family therapy can also help.
Triggers include major life changes like moving, starting a new school, relationship stress, financial problems, or receiving a serious diagnosis. Ongoing stress or limited social support can also increase vulnerability.
Adjustment disorder can make it harder to focus at school or work, keep up with responsibilities, or stay motivated. It can also strain relationships if the person pulls away, feels easily irritated, or has trouble communicating. Physical symptoms like headaches or stomachaches can add to the stress and make everyday tasks feel more difficult.
The most helpful support often comes from listening without judgment, offering reassurance, and helping with everyday stressors when possible. Encouraging the person to stay connected with others, take part in enjoyable activities, or begin therapy can also make a meaningful difference. Patience, kindness, and steady support can help someone feel understood and less alone.
Understanding Adjustment Disorder
Adjustment disorder is characterized by emotional and behavioral changes that occur following an identifiable stressor.
A stressor can be a single event or multiple events that are continuous. The stressor does not necessarily have to be something experienced by the individual. It can also be one experienced by a close group such as the family or community.
Potential stressors include:
- Entering a new school or leaving a school
- Family disruption due to divorce
- Illnesses of self or loved-one
- Death of a loved one
- Natural disasters and disaster news
- Termination of a relationship
- Marital problems
- Work difficulties
- Getting married
- Becoming a parent
Adjustment Disorder Experience
Individuals with an adjustment disorder may experience a sense of hopelessness, frustration, sadness, irritability, and many other emotional and behavioral responses.
Due to the various events that may contribute to an adjustment disorder, the subjective distress can impair the individual’s performance in school, work, social, and other areas of their life. For individuals with a general medical condition, an adjustment disorder may complicate the condition due to the individual’s decline in performance.
Impact of Adjustment Disorder
Adjustment disorders consist of emotional and behavioral symptoms resultant from identified stressors.
Individuals that meet criteria for an adjustment disorder often experience a level of distress, impairing their performance in a social, occupational, and academic realm. Sufferers experience feelings of hopelessness, low mood, withdrawal, agitation, fear, worry, and changes in conduct.
Typically, symptoms will reduce or eliminate following the termination of the identified stressor. If symptoms do not reduce or eliminate within a specified duration of time, a different diagnosis will be assessed.
Prevalence of adjustment disorder
The prevalence of adjustment disorder is estimated to be between 2% and 8% in children in adolescents. While more common in disadvantaged circumstances, adjustment disorders affect men and women equally.
Adjustment Disorder Treatment
Adjustment disorders may present differently for each individual, so it is important to tailor treatment appropriately.
Adjustment disorders typically do not last longer than 6 months, and therefore, realistic treatment goals should be targeted accordingly.
Solution-focused therapy (SFT) is a common approach used to help clients create strategies to effectively navigate specific life problems. SFT is a goal-directed and collaborative model focusing on the solution as opposed to the stressor. The clinician works closely with the client and family members to develop effective coping strategies for problem solving.
Cognitive behavioral therapy (CBT) can also be helpful when addressing the anxiety response that may occur with an identifiable stressor. Through CBT, individuals identify, and challenge irrational thoughts associated with their challenging life events. Exposure and response prevention therapy (ERP) is also utilized to gradually expose and habituate the individual to situations they perceive to be challenging or dangerous. The assigned exposures aid in helping the individual learn new ways of coping with their anxiety. The idea is to modify the learned response (hence the name “response prevention”) so more healthy behaviors and thoughts take their place. ERP takes intensive practice through repeated exposures over many months. For many, ERP in combination with medications provide much-needed relief for people suffering from adjustment disorder.
Resources
Adjustment Disorder in Children: Symptoms, Effects, Treatment
HealthyPlace
Read Article
Adjustment disorder in teens: causes, therapy
AdjustmentDisorders.org
Read Article
Diagnostic and Statistical Manual of Mental Disorders (5th ed.)
American Psychiatric Association. (2013).
Find it on Amazon
Encyclopedia of Children’s Health;
http://www.healthofchildren.com/A/Adjustment-Disorders.html
Science Direct;
https://www.sciencedirect.com/topics/neuroscience/adjustment-disorder