Adjustment Disorder: Information, Symptoms, Treatment and More

An Adjustment Disorder is an anxiety-based mental health condition which occurs when an individual is unable to adjust to or cope with a specific, identifiable event (stressor).

The way someone reacts to the event is seen as abnormal, and more severe than what would normally be expected. A range of events can cause an individual to develop this condition, which will cause symptoms such as low mood, feelings of hopelessness and in severe cases, suicidal ideation.

Adjustment Disorder features similar symptoms to that of Depression – and as such is sometimes referred to as ‘Situational Depression’. The condition is also similar to Anxiety; however Adjustment Disorder involves the presence of a particular stressor.

Adjustment Disorder differs from Post-traumatic Stress Disorder due to the absence of a traumatic event. Despite this, the condition will cause significant distress, and can cause functional impairment.

What are the symptoms of Adjustment Disorder?

Symptoms of Adjustment Disorder can vary slightly from person-to-person. While everyone gets sad or upset when something unpleasant happens, someone with Adjustment Disorder will react in a more intense and extreme way to a specific event – something considered unusual by those around them.

Symptoms are set off by a specific stressor. Unlike cases of Post-traumatic Stress Disorder, the stressor is rarely something traumatic. Possible events include, but aren’t limited to:

• Losing a job
• Witnessing a disturbing event (if traumatic, Post Traumatic Stress Disorder is more relevant)
• End of relationship
• Being the victim of verbal, physical or emotional abuse
• Losing a loved one (although grief is a natural reaction and must be differentiated)
• Financial problems
• Health problems
• Family conflict

As a result of the stressor, the individual will display symptoms such as:

• Low mood
• Tearfulness
• Feelings of hopelessness
• Poor appetite
• Lack of energy
• Anxiety
• Self-harm
• Suicidal ideation

These symptoms will normally appear within three months of the event. They will rarely last longer than six months. This will normally cause the behaviour of an individual to change markedly. They may:

• Struggle to move on with their life
• Struggle to work
• Stop socialising
• Struggle to sleep
• Engage in dangerous and reckless behaviour
• Abuse substances

This is not an exhaustive list of symptoms – it is possible for many other symptoms to manifest for those with Adjustment Disorder.

What are the causes of Adjustment Disorder?

Adjustment Disorder is caused by a specific event, also known as a stressor. The event causes the individual extreme distress. But not everyone develops Adjustment Disorder. Certain risk factors are present.

Those with pre-existing mental health conditions are more vulnerable to developing Adjustment Disorder. Similarly, those who have had a past history of trauma are also at risk.

Those with financial problems are much likelier to react to a stressor in a damaging way. Moreover, many stressors can exacerbate the financial problems – making Adjustment Disorder likelier to appear.

Genetics may also be involved – with an individual believed to be at heightened risk of developing the condition if a parent had Adjustment Disorder or a different trauma-based condition in their life [1].

Adjustment Disorder will often run comorbidly with other mental health conditions. As seen, there are many risk factors involved.

Diagnosis of Adjustment Disorder

If a person believes they are suffering from Adjustment Disorder, it is important to see a Doctor or mental health professional. At an appointment, a doctor will have a discussion with the patient.

They will attempt to investigate the stressor and discuss the impact it is having on the person.

While there is every chance the disorder will clear up on its own if left untreated, not having a chance to discuss distressing events may cause future problems. It is possible that Adjustment Disorder will develop into Depression or Anxiety.

In order for Adjustment Disorder to be diagnosed, the following criteria should be met:

• The individual has been distressed and impaired due to their reaction to a stressor
• This reaction is generally seen as being out of proportion considering all circumstances
• The distress has caused the functioning of the individual to be impaired in multiple contexts, such as social and work-based.

It is possible that a different mental health condition will be diagnosed, if the symptoms better fit elsewhere. There is certainly some crossover between Adjustment Disorder and other areas.

Research suggests that up to 50% of people diagnosed with Adjustment Disorder will go on to develop a more serious mental health condition [2].

How is Adjustment Disorder treated?

Treatment is available for Adjustment Disorder. The aim is for full recovery. Treating the conditions ensures that the condition won’t worsen into a more debilitating mental health condition. Treatment will generally involve:

Talking Therapy

Some form of therapy is normally used to treat Adjustment Disorder. The aim is for a therapist to help the individual come to terms with their stressor, and process it in a healthier way.

Cognitive Behavioural Therapy (CBT): CBT is a type of therapy that is used to treat a range of mental health conditions. CBT involves an individual talking face-to-face with a therapist, although sometimes CBT can be conducted in a group setting. CBT attempts to improve an individual’s wellbeing and mood. The therapy focuses on the link between thoughts, feelings and actions. This can be useful for those with low self-esteem, anxiety, unhelpful personality traits or intrusive thoughts. CBT can help an individual understand their feelings more, and in the long run should lead to an improvement in quality of life.

There are a range of other types of talking therapies available. There are many ways that talking therapy can help. We have more information about this on our Therapy section.

Medication

If symptoms are causing significant distress, it is possible that a medication at a low dose will be prescribed. Antidepressants can take time to work, by which point the distress may have passed, so they are not routinely prescribed.

Antidepressants: Antidepressants can help to improve and regulate mood. They should improve motivation and restore energy. SSRI Antidepressants are the most commonly prescribed. They act on the brain chemical serotonin – which is thought to help in regulating mood and emotion. They may include side-effects such as a dry mouth, sexual problems and nausea, though these should hopefully be short-term. Other classes of antidepressants are available in the event of an inadequate reaction.

It is possible that a benzodiazepine could be prescribed in the short-term. But this is rather rare.

Benzodiazepines: Benzodiazepines are fast-acting sedatives, which can relax an individual and improve their mood. Any anxiety should fade rapidly upon consumption. The individual should therefore have an improved level of functioning. Benzodiazepines cannot be taken for more than a few weeks, due to acute risk of both physical and psychological dependence.

Summary

The majority of people with Adjustment Disorder will recover fully, especially if they have no prior history of mental health illness. Those however with past mental health issues may be more susceptible to future issues.

Accessing treatment certainly helps, and will often result in recovery. For more information, you can navigate around our website.

See Also

• PTSD & Trauma Section
• What Is The Prognosis for PTSD & Trauma Conditions?
• Therapy Homepage
• Medicine Homepage