Adjustment Disorder: Signs, Symptoms, and Treatment

Key Takeaways

• Adjustment Disorder is a short-term condition triggered by specific stressors or life changes.
• Common symptoms include crying, insomnia, anxiety, and difficulty managing daily tasks.
• Early treatment with psychotherapy can support recovery.

It’s natural to feel stressed when life presents challenges. Events like job loss, moving, or the death of a loved one can trigger anxiety, overwhelm, or hopelessness.

Sometimes, though, our bodies may react to a specific stressor more than expected, making it difficult to move through regular activities, leading to adjustment disorder with anxiety.

Although this condition can feel overwhelming at first, it is typically temporary and tends to improve once the stressor is gone or you've had time to adjust.

What is Adjustment Disorder?

Adjustment disorder, also known as stress response syndrome, is a short-term condition in which a person experiences more stress than is perceived as normal in response to an event.

For example, if a person is still mourning the breakup of a three-month-long relationship six months later, they may be suffering from adjustment disorder.

Adjustment disorder often results in serious disruptions to a person’s daily life and personal relationships. It can be difficult for the people around them to understand what a person with adjustment disorder is experiencing, as people tend to see situations in the way they’ve experienced them.

For example, say Laney has been laid off from her job. Six months later, instead of looking for a new job, Laney is still lying in bed every day, prompting her partner to be angry with her because they are being saddled with paying the bills and cleaning the house.

What are the Symptoms of Adjustment Disorder?

Adjustment disorder can look different for everybody, but symptoms typically include:

• Frequent crying
• Avoidance of important tasks
• Insomnia
• Lack of focus
• Feelings of hopelessness
• Behaviors that are more reckless than normal
• Withdrawing from friends and loved ones
• Changes in appetite
• Anxiety
• Fatigue
• Reliance on drugs or alcohol
• Thoughts of suicide

Symptoms normally start within three months of a stressful event and usually don’t last for longer than six months; however, some cases can last longer, especially with ongoing situations, such as unemployment or illness.

Adjustment disorder is not the same as clinical depression or post-traumatic stress disorder (PTSD), although some symptoms are similar. The most crucial difference is that the majority of adjustment disorders rarely last longer than six months.

What are the Causes of Adjustment Disorder?

According to Medline Plus, a service of the National Library of Medicine (NLM), the causes of adjustment disorder are wide-ranging and can include the following situations:

• Death of a loved one
• Divorce or problems with a relationship
• General life changes
• Illness or other health issues in yourself or a loved one
• Moving to a different home or a different city
• Unexpected catastrophes
• Worries about money

For younger people, stressors can include problems at school, issues with parents or siblings, or coming to terms with their sexuality.

It’s difficult to predict who will develop adjustment disorder after experiencing the same stress. Factors like your social skills before the event and your past coping mechanisms may influence your response.

What are the Types of Adjustment Disorder?

There are several types of adjustment disorders, including anxiety, depression, or a mix of both, each affecting emotional responses differently. Here are the six main types of adjustment disorders:

1. Adjustment disorder with depressed mood

People who are diagnosed with this type of adjustment disorder tend to experience feelings of hopelessness and despair, as well as crying.

2. Adjustment disorder with anxiety

Adjustment disorder with anxiety features more nervousness, jitters, and feelings of panic. People with this diagnosis tend to struggle more with concentration and may have problems with forgetfulness.

Adjustment disorder with anxiety in children tends to be a result of separation anxiety, when a child is apart from their parents or other loved ones for a prolonged period.

3. Adjustment disorder with mixed anxiety and depressed mood

People experiencing both anxiety and depression may have adjustment disorder with mixed anxiety and depressed mood.

4. Adjustment disorder with disturbance of conduct

This type of adjustment disorder manifests more with behavioral symptoms than emotional ones. It can result in reckless behavior such as starting fights or drinking to excess. Teens with this disorder may skip school or damage property.

5. Adjustment disorder with mixed disturbance of emotions and conduct

Adjustment disorder with mixed disturbance of emotions and conduct is a combination of symptoms of anxiety, depression, and reckless behavior.

6. Adjustment disorder unspecified

Those with an unspecified adjustment disorder experience symptoms that are unrelated to those associated with the other types of adjustment disorder. These can include more physical symptoms, such as loss of appetite or trouble sleeping.

What Increases the Risk of Adjustment Disorder?

Adjustment disorder can affect people of all ages, though certain factors may increase vulnerability, such as a history of mental health challenges or upbringing. Additional risk factors include limited social support, poor coping skills, and being female, as women are generally more susceptible.

Stress from major life events, ranging from divorce and job loss to life-threatening experiences or having a baby, can also increase the risk of developing an adjustment disorder.

Some of the key factors that increase the risk of adjustment disorder include:

• History of mental health challenges
• Poor coping skills
• Exposure to significant life stressors
• Lack of social support
• Internalization of stress

What are the Possible Complications Related to Adjustment Disorders?

Adjustment Disorder is typically a short-term condition; however, it can lead to more serious complications if left untreated.

Some individuals may experience thoughts of self-harm or develop challenges with substance use. If left unaddressed for long, adjustment disorder also has the potential to develop into more chronic mental health conditions, such as major depressive disorder or generalized anxiety disorder.

Early recognition and treatment are key to preventing complications from adjustment disorder and supporting a healthier recovery process.

Adjustment Disorder in Children vs Adults

Adjustment disorder can impact both children and adults, but symptoms can appear differently in each.

The table below outlines how adjustment disorder manifests differently across age groups, highlighting common symptoms and the influence of cultural factors:

‍

How are Adjustment Disorders Diagnosed?  

Adjustment disorders are generally diagnosed by a qualified professional, such as a mental health care provider.

The provider conducts a comprehensive evaluation that takes symptoms and their duration into account, in addition to overall health, medical history, and life circumstances.

When to See a Doctor or Adjustment Disorder Therapist  

If you or someone you care about has gone through a period of significant stress and is experiencing prolonged behavioral or emotional changes that impact regular day-to-day activities, like work, hygiene, or sleep, it's time to ask for help.

If you or someone you know is experiencing thoughts of suicide or self-harm, seek medical attention right away by calling 911, your local emergency services number, or the Suicide and Crisis Lifeline at 988.

How to Choose an Adjustment Disorder Therapist

A therapist who specializes in short-term, solutions-focused therapies, such as Brief Dynamic Therapy or Cognitive Behavioral Therapy (CBT), can be a good fit to help treat adjustment disorder.

Don't hesitate to ask potential therapists about their experience treating adjustment disorders, their approach to therapy, and what you can expect from treatment. Finding a mental health provider who is the right fit can take time, but it’s important to find someone who makes you feel comfortable and can work with your schedule.

The relationship between you and your provider plays a crucial role in successful treatment. Finding a provider you trust and feel comfortable with can greatly impact your recovery.

How is Adjustment Disorder Treated?

Adjustment disorder is typically treated with psychotherapy, also referred to as talk therapy.

There are different types of psychotherapy approaches, including individual and group settings, as well as different therapy treatment methods. CBT is a common approach that helps people identify negative thought patterns and manage responses to stressful situations.  

Psychotherapy (Individual, family, group)

Individuals may participate in both long-term and short-term forms of psychotherapy, and depending on the age and situation, formats may vary. Individuals may meet with a mental health provider in a one-on-one setting, either in person or online.

Some mental health providers may also provide couples therapy or group therapy for adults and children alike.

Medication

Medication is sometimes combined with psychotherapy to enhance individual responsiveness to treatment. It can be helpful if anxiety or depression symptoms are severe and impairing your daily activities, like work, sleep, and basic hygiene.

Outlook and Prognosis for Adjustment Disorder

Prognosis for adjustment disorder varies from member to member, but overall, it can be positive for those who seek treatment early. With appropriate therapy, support, and coping strategies, individuals can experience positive outcomes without long-term complications.

Adjustment disorder is a short-term condition caused by a specific stressor. With proper support, most people see significant improvement within a few months once the stressor is resolved or they've adapted to the change.

Can Adjustment Disorders be Avoided?

While you can't always avoid stressful life events, building resilience and strong coping skills can help you navigate difficult times more effectively. Maintaining supportive relationships, practicing stress management techniques, and seeking help early when you're struggling can help with coping mechanisms when challenges arise.

Talkspace offers the flexibility to connect with a therapist when you need it most. With personalized support from a licensed therapist, you can strengthen your emotional resilience and gain the tools needed to handle future stressors.

Start building a stronger foundation for your mental health. Connect with a licensed therapist today.

Frequently Asked Questions (FAQs)

How do therapists differentiate Adjustment Disorder from normal stress?

Adjustment disorder symptoms are more intense than typical stress. To diagnose adjustment disorder, a therapist will evaluate your personal circumstances, recent life changes or stressors, the severity of your symptoms, and how long you've been experiencing them.

Can adjustment disorder turn into PTSD or develop into another mental health condition?

Adjustment disorder can evolve into post-traumatic stress disorder (PTSD) if the stressor involves a traumatic event and symptoms persist or worsen over time. Without proper support, it may also develop into other mental health conditions like anxiety or depression.

Can adjustment disorder symptoms appear weeks or months after the stressful event?

Yes, adjustment disorder symptoms can appear weeks or even months after a stressful event, as individuals may initially cope with the situation before the emotional impact becomes more evident. The delayed onset of symptoms can make it difficult to immediately recognize the connection to the stressor.

Is adjustment disorder commonly misdiagnosed as anxiety or depression?

Yes, adjustment disorder is often misdiagnosed as anxiety or depression because its symptoms overlap with those of these conditions. However, unlike anxiety or depression, adjustment disorder is specifically triggered by a stressful event and is typically short-term, resolving once the individual adapts to the change or the stressor is removed.

What happens if adjustment disorder with anxiety is left untreated?

If left untreated, adjustment disorder with anxiety can worsen, leading to chronic anxiety, depression, or other mental health challenges. It can also impact relationships, work, and overall well-being.

References

1. National Library of Medicine. Adjustment disorder. MedlinePlus. https://medlineplus.gov/ency/article/000932.htm. Accessed, January 29, 2023.

‍