An adjustment disorder is defined by an excessive or unhealthy response to a stressful event or change in a person’s life.
Although adjustment disorders are an emotional reaction to an event, there is not a single direct cause between the two.
People vary in their past experiences, temperament, coping skills and vulnerability. Stressors also differ in how strong they are, how long they last and what effect they have.
Most of the time, we adjust to stressors and changes within a few months; however if you continue to have emotional or behavioural reactions that lead you to feeling depressed and anxious, you may be experiencing adjustment disorder.
While adjustment disorders occur equally in males and females, children and adolescents are more likely to experience them (although they do also occur in adults). Other risk factors include:
- Life experiences such as childhood trauma, which can make an individual more susceptible to excessive stress responses;
- Temperament may also heighten an individual’s susceptibility to developing an adjustment disorder;
- Being single;
- Lacking a social support system;
- Being affected by comorbid mental disorders;
- Living in an urban area.
Stressful live events can trigger adjustment disorders, including:
- Relationship or interpersonal problems;
- Death of a loved one;
- Problems at school or work;
- Changes in situation such as going away for school, having a baby or retirement;
- Ongoing stressors such as chronic illness.
Signs of Adjustment Disorders
- As in all adjustment disorders, the emotional response to the stressor is considered excessive compared to what would be expected;
- The reaction interferes with social, occupational, interpersonal and educational functioning;
- Adolescent symptoms of adjustment disorders can be externalizing behaviours, such as acting out;
- In adults, adjustment disorders exhibit more depressive symptoms;
- Lack of appetite;
- Difficulty sleeping;
- Feeling sad or teary;
- Worrying, nervousness or feeling anxious;
- Feeling overwhelmed;
- Withdrawing from social supports;
- Avoiding important things;
- Suicidal thoughts.
Onset of symptoms is generally within 3 months of the stressful event and last no longer than 6 months. However, chronic adjustment disorders can persist beyond this period if the stressor is ongoing, such as unemployment.
Symptoms of adjustment disorder can overlap with symptoms of depressive disorder and PTSD.
Adjustment Disorder vs Post Traumatic Stress Disorder – Adjustment disorder is not the same as post traumatic stress disorder. PTSD is a response to a life-threatening event that generally begins 1 month following the event, and symptoms persist longer than 6 months. By comparison, adjustment disorders tend to last for less than 6 months.
Adjustment Disorder vs Major Depressive Disorder – Unlike major depressive disorder, adjustment disorders don’t typically carry the same physiological symptoms as depression (such as loss of appetite, sleep disturbance, low energy) or elevated levels of severity.
Most people who experience adjustment disorders recover completely. However, sometimes symptoms may develop into major depressive disorders in people who are at risk for developing mood disorders.
Treatment may include:
- Psychotherapy where psychologists will also screen for other mental illness such as PTSD, depression or anxiety disorders;
- Medications including anti depressants;
- Support groups
To build your resilience to deal with stressful situations it helps to
- Stay connected with friends and family;
- Engage in activities that bring you joy and pleasure;
- Have a healthy lifestyle;
- Build adaptive coping skills;
- Work to problem solve.
Author: Tara Pisano, BA (Psych) (Hons), M Psych.
Tara Pisano is a Brisbane psychologist with a special interest in early intervention in adolescents and young adults, as this is when three quarters of mental health conditions emerge. In her practice, she draws on a range of evidence-based therapies such as CBT, DBT, IPT, ACT and Motivational Interviewing, to promote recovery and positive outcomes.
To make an appointment with Tara Pisano, try Online Booking. Alternatively, you can call M1 Psychology Loganholme on (07) 3067 9129 or Vision Psychology Wishart on (07) 3088 5422.
- Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, American Psychiatric Association.
- Gabbard, G. O. (2014). Adjustment disorders. In: Gabbard’s Treatments of Psychiatric Disorders. 5th ed. Arlington, Va.: American Psychiatric Association; http://www.psychiatryonline.org.