Health Library

Adjustment Disorder

Definition

Adjustment disorder is a group of symptoms linked to a stressful event. These symptoms are more severe than they should be. This can make it hard to return to normal day-to-day life. The event may be personal, like a divorce, or large-scale event, like a natural disaster.

Causes

Adjustment disorder is caused by stress or changes in your life. Genes and past stressful events may also play a role.

Risk Factors

Things that may increase the risk of adjustment disorder are:

  • Current or history of other mental health problems such as post-traumatic stress disorder
  • Problems within family or poor support system
  • Major life changes and stress in childhood

Any stressful event can lead to an adjustment disorder. Some examples include:

  • School challenges
  • Loss of work or retirement
  • Illness
  • Death of loved ones
  • Major life change such as marriage, divorce, baby, or moving
  • Being in the military or going to war
  • Natural or other widespread disasters

Symptoms

Adjustment disorder starts within 3 months of the event. It can last up to 6 months or more after the stress is gone. There are different types of adjustment disorder. Symptoms can vary but may include:

  • Feeling sad and hopeless
  • Loss of motivation and self-esteem
  • Hard time finding pleasure in things that used to enjoy
  • Frequent crying
  • Feel overwhelmed easily
  • Excess worry
  • Feel that nothing will work out well
  • Bursts of anger
  • Drug or alcohol misuse
  • Fighting or seeking revenge
  • Problems with relationships, school, or work

Diagnosis

The doctor will ask about symptoms and past health. They may also ask about any major changes or problems in daily life. The doctor will use the answers to make a diagnosis.

Treatment

Treatment can help to ease the impact of the stress. This may lower the effect on day to day life.

Counseling includes talk therapy. The type of therapy will vary based on needs. It can include coaching about stress and learning habits that may help to address them. Therapy can also help to address problems in relationships. It may include one-on-one, couple, family, or group sessions.

Therapy may also work on the thought process around stress and coping skills. It may help to manage stressful events in the future.

Medicines may be used to ease some symptoms. It may only be used for a short period to help progress in therapy.

Prevention

There are no steps to prevent adjustment disorders since the cause is unclear.

Resources

American Psychiatric Association
https://www.psychiatry.org

National Institute of Mental Health
https://www.nimh.nih.gov

Canadian Resources

Canadian Mental Health Association
https://cmha.ca

Canadian Psychiatric Association
https://www.cpa-apc.org

References

Adjustment disorder. Johns Hopkins Psychiatry Guide. Available at: https://www.hopkinsguides.com/hopkins/view/Johns%5FHopkins%5FPsychiatry%5FGuide/787068/all/Adjustment%5FDisorder. Updated October 29, 2017. Accessed April 6, 2020.

Fernández A, Mendive JM, Salvador-Carulla L, et al. Adjustment disorders in primary care: prevalence, recognition and use of services. Br J Psychiatry. 2012;201:137-42.

Sundquist J, Ohlsson H, Sundquist K, et al. Common adult psychiatric disorders in Swedish primary care where most mental health patients are treated. BMC Psychiatry. 2017;17(1):235.

Adjustment disorders. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/psychiatric-disorders/anxiety-and-stressor-related-disorders/adjustment-disorders. Updated July 2018. Accessed August 30, 2018.