What is an Adjustment Disorder?

In the interest of centralizing tools and resources, I’ll be featuring posts on some of the most commonly diagnosed mental health concerns. This post is a living document and is based on the DSM-5-TR, published in 2022, the latest guidebook for mental health diagnoses.

First up… Adjustment Disorder…

What is an Adjustment Disorder?

Adjustment disorder is a short-term condition that happens when you have great difficulty managing with, or adjusting to, a particular source of stress, such as a major life change, loss, or event. Because people with adjustment disorders often have some of the symptoms of clinical depression, such as tearfulness, feelings of hopelessness, and loss of interest in work or activities, adjustment disorder is sometimes informally called "situational depression."

An adjustment disorder is an emotional or behavioral reaction to a stressful event or change in a person’s life. The reaction is considered an unhealthy or excessive response to the event or change within three months of it happening.

Stressful events or changes in the life of your child or adolescent may be a family move, the parents’ divorce or separation, the loss of a pet, or the birth of a sibling. A sudden illness or restriction to your child’s life due to chronic illness may also result in an adjustment response.

Subtypes of Adjustment Disorder

There are six subtypes of adjustment disorder that are based on the type of major symptoms experienced. The following are the most common symptoms of each of the subtypes of adjustment disorder. However, each client may experience symptoms differently:

• Adjustment disorder with depressed mood.

  • Depressed mood

  • Tearfulness

  • Feelings of hopelessness

• Adjustment disorder with anxiety.

  • Nervousness

  • Worry

  • Jitteriness

  • Fear of separation from major attachment figures

• Adjustment disorder with anxiety and depressed mood. A combination of symptoms from both of these conditions are present.

• Adjustment disorder with disturbance of conduct.

  • Violation of the rights of others

  • Violation of society’s norms and rules (truancy, destruction of property, reckless driving or fighting)

• Adjustment disorder with mixed disturbance of emotions and conduct. A combination of symptoms from all of the above subtypes is present (depressed mood, anxiety and conduct).

• Adjustment disorder unspecified. Reactions to stressful events that do not fit in one of the above subtypes are present. Reactions may include behaviors like social withdrawal or inhibitions to normally expected activities, like school or work.

Adjustment Disorder vs. Major Depression

Adjustment syndrome/stress response syndrome has some symptoms that overlap with those of major depression. Unlike major depression, an adjustment disorder doesn't involve as many of the physical and emotional symptoms of clinical depression (such as changes in sleep, appetite, and energy) or high levels of severity (such as suicidal thinking or behavior).

Adjustment Disorder vs. Posttraumatic Stress Disorder (PTSD)

An adjustment disorder/stress response syndrome is not the same as posttraumatic stress disorder (PTSD). PTSD is a reaction to a life-threatening event that happens at least 1 month after the event, and its symptoms tend to last longer than in adjustment disorders/stress response syndromes. By comparison, adjustment disorders/stress response syndromes rarely last longer than 6 months.

Symptoms of Adjustment Disorder/Stress Response Syndrome (AD/SRS)

Adjustment disorder/stress response syndrome changes the way you feel and think about the world and your place in it. A person with AD/SRS has emotional and/or behavioral symptoms as a reaction to a stressful event. These symptoms generally begin within 3 months of the event and rarely last for longer than 6 months after the event or situation has ended.

In adjustment disorder/stress response syndrome, the reaction to the stressor is greater than what is typical or expected for the situation or event. The symptoms may cause problems with a person's ability to function; for example, the person may have trouble with sleep, work, or studying. It can have a wide variety of symptoms that are changes from someone's usual self, which may include:

• Feeling of hopelessness

• Sadness

• Frequent crying

• Anxiety (nervousness)

• Worry

• Headaches or stomachaches

• Palpitations (an unpleasant sensation of irregular or forceful beating of the heart)

• Withdrawal or isolation from people and social activities

• A new pattern of absence from work or school

• New and out-of-the-ordinary dangerous or destructive behavior, such as fighting, reckless driving, and vandalism

• Changes in appetite; either loss of appetite or overeating

• Problems sleeping

• Feeling tired or without energy

• Using alcohol or other drugs more

Symptoms in children and teens tend to be more behavioral in nature, such as skipping school, fighting, or acting out. Adults, on the other hand, tend to have more emotional symptoms, such as sadness and anxiety.

Additional Reading:

https://www.mayoclinic.org/diseases-conditions/adjustment-disorders/diagnosis-treatment/drc-20355230