Adjustment Disorder

Written by Rose Kivi | Published on July 16, 2012
Medically Reviewed by George Krucik, MD

What Is Adjustment Disorder?

Adjustment disorder is an unexpectedly strong emotional or behavioral reaction that occurs in response to an identifiable stressful life event or life change that occurred within the previous three months.

Types of Adjustment Disorder

Adjustment disorder can be acute (lasting less than six months) or chronic (lasting longer than six months). Keep in mind that the definition of adjustment disorder does not allow the symptoms to last longer than six months after the stressor has terminated. A chronic diagnosis is only allowed if the stressful event or life change is persistent. In addition to an acute and chronic diagnosis, there are six subtypes of adjustment disorder that are classified by the predominant symptoms you are experiencing. The six subtypes are:

  • adjustment disorder with depressed mood
  • adjustment disorder with anxiety
  • adjustment disorder with mixed anxiety and depressed mood
  • adjustment disorder with disturbance of conduct
  • adjustment disorder with mixed disturbance of emotions and conduct
  • unspecified adjustment disorder (problematic thinking and behavior that is not classifiable by the other adjustment disorder subtypes

What Causes Adjustment Disorder?

Adjustment disorder develops as a reaction to a stressful life event or a major life change. Events or changes that may cause you to develop adjustment disorder include:

  • marital problems
  • relationship problems
  • divorce
  • family conflict
  • sexuality issues
  • health problems
  • death of a loved one
  • unexpected catastrophes
  • financial problems
  • work changes
  • school changes
  • moving
  • major life changes
  • general life changes
  • ongoing stressful life events

Who Is at Risk of Developing Adjustment Disorder?

Research is limited on how often adjustment disorder occurs, although it is thought to be a common condition. Children and adults of both sexes suffer from it equally, but there is no way to determine who will develop adjustment disorder in response to a stressor. Certain factors increase your susceptibility to developing the disorder. Risk factors include:

  • age (adolescents may not be able to cope with stressors as well as adults)
  • a lack of emotional development
  • a lack of flexibility for life changes
  • a lack of good coping skills
  • a lack of social skills
  • a lack of a support system
  • past experiences
  • other mental health problems
  • genetic factors
  • intelligence

What are the Symptoms of Adjustment Disorder?

Symptoms of adjustment disorder vary according to the subtype. You may experience one or more of the following symptoms if you have adjustment disorder:

  • agitation
  • anxiety
  • excessive worrying
  • poor concentration
  • difficulty sleeping
  • feeling overwhelmed
  • depression
  • inappropriate conduct
  • avoiding family and friends
  • thoughts of suicide
  • suicidal behavior
  • trembling or twitching
  • heart palpitations
  • physical complaints

How Is Adjustment Disorder Diagnosed?

Your healthcare provider will ask you questions to determine if you meet the criteria for a diagnosis of adjustment disorder. You must meet all of the following criteria to be diagnosed with adjustment disorder:

  • your symptoms must have developed within three months of the stressor
  • your symptoms are more severe than would normally be expected in reaction to your stressor and is causing distress, social impairment, or occupational impairment
  • your symptoms are not caused or exacerbated by another disorder
  • your symptoms are not part of the normal grieving and sorrow experienced after the death of a loved one

How Is Adjustment Disorder Treated?

The goal of treatment for adjustment disorder is to relieve your symptoms and to help you develop coping skills for the future. Treatment options for adjustment disorder include:

Psychotherapeutic Counseling

Psychotherapeutic counseling helps you to identify your stressors, learn coping skills, and get support. Forms of psychotherapeutic counseling include:

Medication

Your healthcare provider may prescribe medications to help relieve your symptoms while you are undergoing psychotherapeutic counseling. Medications are rarely used as a sole treatment for adjustment disorder, because they only temporarily relieve the symptoms, unlike psychotherapeutic therapy, which provides long-term or permanent relief of symptoms. Medications that might be prescribed to you include:

  • antianxiety medicines
  • antidepressant medicines
  • antipsychotic medicines (uncommon)
  • stimulants (if you are withdrawn)

Prognosis

Most adults respond well to treatment for adjustment disorder and have a good long-term prognosis, while adolescents may not respond as well to treatment and may develop major psychiatric illnesses.

Prevention

There is no known guaranteed way to prevent adjustment disorder. You may be able to reduce your risk of developing the disorder by doing the following:

  • seek support from family and friends
  • talk to a healthcare professional if you start to feel stressed
  • try to have a flexible attitude regarding where your life will lead
  • think positively
  • live a healthy lifestyle (healthy diet and exercise)
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Article Sources:

  • American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR Fourth Edition (Forth Edition Text Revision ed.). : Amer Psychiatric Pub.
  • Carta et al., M. G. (2009). Adjustment disorder: epidemiology, diagnosis and treatment. Clinical Practice & Epidemiology in Mental Health, 5: 15.
  • Benton et al., T. D. (n.d.). Medscape: Medscape Access. Medscape: Medscape Access. Retrieved April 13, 2012, from http://emedicine.medscape.com/article/292759-overview#aw2aab6b6

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