Adjustment Disorder

Adjustment disorders (AD) are short-term conditions that occur after a traumatic life event. Clinically called “stress response syndrome,” the disorder leads to feelings of hopelessness, malaise, disinterest in previously enjoyed activities, difficult sleeping, loss of appetite and anxiety. Unlike clinical depression, which involves similar symptoms, adjustment disorders are caused by an external stressor or event, rather than genetics or physiological factors. Moreover, adjustment disorder rarely lasts for more than six months. If the condition is not resolved through treatment, however, it may develop into long-term depression.

Adjustment Disorder Triggers

Numerous events, both internal and external, can cause an adjustment disorder. Common triggers include living through a natural disaster, such as a hurricane or flood, experiencing the death of a loved one, and having been the victim of a crime; but events need not necessarily be severe or universally traumatic. Sometimes positive events, such as having a baby or starting a new job, can result in an adjustment disorder. In young sufferers, triggers might include a move to a new school or parent remarrying.

Identifying an Adjustment Disorder

Symptoms of an adjustment disorder include depressed mood, increased anxiety, changes in social behavior, or avoiding social situations. An individual may also have strong reactions to normal events — for example, breaking into tears because of traffic or becoming uncharacteristically angry or reckless over a long line at the grocery store. A client may even present with physical symptoms, such as heart palpitations, agitation, twitching or shaking, general aches, including headache, stomach ache and chest pain.

Adjustment Disorder Behaviors

Someone suffering from adjustment disorder may experience trouble sleeping, a lack of appetite, constant worry, frequent crying, feelings of hopelessness, difficulty concentrating, overwhelm, withdrawal from family or friends, avoidance of important obligations and even suicidal behavior or thoughts. Symptoms typically begin within a few months of the stressful event. If the stressor is ongoing, the disorder will persist. How well someone handles stress is subject to many factors, including genetics and existing coping strategies for stress.

Adjustment Disorder Risk Factors

Although adjustment disorder affects all ages and demographics, some groups are more at risk than others. Other than stressful life situations, risk factors may include young age, identifiable psychosocial and environmental problems, and repeated traumas. Younger individuals are more likely to develop the disorder because they have yet to cultivate effective coping methods.

While the disorder may not seem severe, sufferers who do not get the treatment they need may later suffer longer-term psychiatric disorders. For this reason, medical professionals have become more inclined to treat the disorder when it presents, instead of employing a previously common method of “watchful waiting.” Other than professional help, younger sufferers need support from parents or caregivers. Encouraging sufferers to express their emotions, while offering understanding and guidance, has proven helpful. Re-engaging in healthy habits and hobbies is also helpful. Even allowing the individual to make small, simple decisions can encourage healing.

Adjustment Disorder vs. PTSD

Adjustment disorder is similar to post-traumatic stress syndrome in that both are reactions to external events, but these disorders are quite different. Post-traumatic stress syndrome is characterized by persistent feelings of stress, fear and anxiety after a traumatic event, such as living through a natural disaster or a violent crime, even when a person is no longer in danger. Symptoms include vivid flashbacks, nightmares, anxiety and distorted emotions, such as misplaced guilt or blame for the event. These symptoms typically arise within months of the event and may last for years without treatment.

Adjustment Disorder Treatment

Recommended treatment for adjustment disorder may include individual psychotherapy, family therapy, group therapy, crisis intervention, and behavior therapy. Therapy typically focuses on helping a client develop coping mechanisms and healthy ways to manage future stressful events. Meditation or other techniques for relaxation are also common.

Treatment should also help individuals with adjustment disorder learn to change how they view stress, including their role in how they react to stress. Treatment often involves developing positive coping methods, while discouraging negative reactionary responses. If a substance abuse disorder has developed alongside an adjustment disorder, clients will need separate, dedicated treatment for these co-occurring conditions. Depending on the substances involved and severity of the addiction, treatment may start with a medical detox before starting other therapies.

It is normal for individuals to respond to a stressful life event emotionally, but the right awareness and treatment can help individuals who have suffered from adjustment disorders learn to recognize that the intense emotion and stress is temporary. If you or a loved one is struggling to recover after a traumatic event, it is important to seek help.