What is adjustment disorder?
Adjustment disorder is an abnormal emotional and/or behavioral reaction to a stressful period of one’s life, often surrounding a major event, such as a breakup or a divorce, or major life change, such as moving house or becoming unemployed.
Symptoms of adjustment disorder include those associated with [depression](/conditions/depressive-episode/, such as a depressed mood and hopelessness, as well as those associated with anxiety, such as nervousness and worry. These symptoms will normally begin within three months of the onset of the stressor and last for no longer than six months.
Adjustment disorder is most common in children and adolescents, but adults may also develop the condition. Treatment is typically aimed at relieving the symptoms and will normally be based upon a form of talk therapy, such as cognitive behavioral therapy or group therapy.
Symptoms of adjustment disorder
The symptoms of adjustment disorder will usually appear within three months of the stressful event or life change and disappear within six months. If adjustment disorder does not resolve after this time, a new diagnosis will be considered. Most commonly, adjustment disorder that does not resolve develops into depression.
Generally, the symptoms will significantly interfere with the functioning of an individual's life, for example by making it difficult to:
- Attend school.
Symptoms of adjustment disorder vary according to the age of the person experiencing the condition. Children and adolescents are more likely to display behavioral symptoms, such as acting out, whereas adults tend to experience more emotional symptoms, such as anxiety and a depressed mood.
There are six subtypes of adjustment disorder, each with its own specific set of symptoms:
- Adjustment disorder with depressed mood: Symptoms may include feelings of depression, sadness and hopelessness. Individuals may also be highly tearful and experience bouts of crying.
- Adjustment disorder with anxiety: Symptoms may include feelings of nervousness, apprehension and worry. Individuals may also be excessively jittery and fearful of separation, from parents or other significant people.
- Adjustment disorder with mixed anxiety and depressed mood: An individual will experience a mixture of the symptoms listed in both subtypes above.
- Adjustment disorder with disturbance of conduct: An individual will experience a change in behavior, typically characterized by a lack of respect for the rights and feelings of others, as well as a lack of respect for social norms and rules.
- Adjustment disorder with mixed disturbance of emotions and conduct: An individual will experience a combination of all the symptoms listed above.
- Adjustment disorder unspecified: An individual experiences a severe reaction to a stressor, but it does not fit into any of the above categories. Symptoms may include social withdrawal and introversion.
People experiencing symptoms of adjustment disorder should receive a psychological evaluation from a psychiatrist or other mental health professional. In addition, the free Ada app can be used to carry out a symptom assessment.
Causes of adjustment disorder
Adjustment disorder is a reaction to a particular stressor, whether a stressful life event or a major life change. There is no clear way to identify why some people develop adjustment disorder and why some do not, with factors playing a role including a person's:
- Coping skills
- Past experiences
- Social skills
Common stressors that may lead to adjustment disorder in a person of any age include:
- Giving birth
- Being bullied
- Divorce or relationship problems
- Moving to a new house or new location
- Financial difficulties
- The death of a loved one
Common stressors in children and young adults include:
- Parental divorce or separation
- Problems at school such as bullying
- Sexuality issues
- Parental neglect
Diagnosing adjustment disorder
A diagnosis of adjustment disorder usually requires a full psychological evaluation by a psychiatrist or other mental health professional. This evaluation will typically take into account, among other factors, the following:
- Past experiences
- Sources of stress
When diagnosing children or adolescents, parents may also be present during the evaluation.
The key criteria for diagnosing adjustment disorder are:
- The symptoms must have begun to appear within three months of the stressor occurring.
- The condition must be characterized by stress that is in excess of what would be considered normal under the circumstances.
- The symptoms must be distinct from similar disorders, such as post-traumatic stress disorder.
Treating adjustment disorder
The chosen treatment method for adjustment disorder will usually depend on a variety of factors, including:
- Severity of symptoms
- The subtype being experienced
- Specific factors such as the likely outcome of the stressor
Individual psychotherapy will usually take a cognitive-behavioral approach and, because the condition is defined as short-term, will typically be solution-focussed. In other words, the psychotherapy will be designed to better equip the individual to deal with their particular life problem.
Family therapy will generally be recommended in cases of childhood or adolescent adjustment disorder. It is designed to overcome conflicts in family life and improve communication skills among family members. It may also be useful in teaching family members how to support the child/adolescent who is experiencing adjustment disorder.
In some cases, discussing the disorder and sharing coping techniques with a group of people also experiencing adjustment disorder may be a useful treatment method. Group therapy can also help the person improve their communication skills and can be a useful source of support and encouragement.
Medication is generally not prescribed in cases of adjustment disorder.
Preventing adjustment disorder
There is no known way to prevent the onset of adjustment disorder. Identifying the condition early and seeking professional help can be effective in reducing the severity of adjustment disorder and improving general wellbeing.
Adjustment disorder FAQs
Q: What is the difference between adjustment disorder and post-traumatic stress disorder (PTSD)?
A: Although adjustment disorder and post-traumatic stress disorder (PTSD) can have overlapping symptoms, the key difference between the two conditions is their cause. Adjustment disorder is typically triggered by a stressful event or phase, but one that is within the normal range of human experience, such as a marriage breakup or financial difficulty. Conversely, PTSD is triggered by an exceptional event, normally one involving:
- The threat of death
- Serious injury
The event triggering PTSD can cause feelings of:
- Extreme fear
PTSD can also be a long-term condition that may not present itself for several months or years after the initial event. Adjustment disorder, on the other hand, must present itself within three months of the triggering event.
Q: What is the difference between adjustment disorder and depression?
A: Adjustment disorder, especially the depressed mood subtype, and depression are similar conditions that can only be accurately differentiated by a doctor or other medical professional. It is generally thought that the major difference between the two conditions is that adjustment disorder is triggered by an identifiable stressful event or phase, whereas depression is more generalized, making it unclear what exactly is causing the condition. Adjustment disorder will also generally be a short-term condition.
Good to know: If a person who has been diagnosed with adjustment disorder continues to experience mental distress after six months, it is likely that the adjustment disorder has developed into another mental health condition, most commonly depression. In this event, a new diagnosis will be considered. Other conditions developing from adjustment disorder are usually anticipated to be longer-lasting and to require ongoing treatment. 
Clinical Practice & Epidemiology in Mental Health. “Adjustment Disorder: epidemiology, diagnosis and treatment.” June 26, 2009. Accessed October 2, 2017. ↩ ↩