• Adjustment Disorder


    Adjustment disorder is an excessive, lengthy reaction to a stressful event or situation. It could be 1 stressor or a combination of stressors affecting 1 person or a group of people. This reaction seriously damages social and occupational functioning.
    There are several subtypes of the disorder, including adjustment disorder with:
    • Depressed mood
    • Anxiety
    • Mixed anxiety and depressed mood
    • Disturbance of conduct
    • Mixed disturbance of emotions and conduct


    Adjustment disorders develop in reaction to stressful life events or major life changes. Some common stressors are:
    • Relationship problems
    • Financial difficulties
    • Family conflict
    • School issues
    • Work changes
    • Major life changes
    • Health problems
    • Divorce
    • Death of loved ones
    • Moving
    • Combat
    • Sexuality issues
    In some cases, ongoing problems, such as living in an unsafe, crime-ridden neighborhood, may cause the development of an adjustment disorder over a longer period of time.

    Risk Factors

    Women may be at a higher risk for adjustment disorder than men. However, risk for boys and girls is similar. Other factors that may increase your risk for adjustment disorder may include:
    • Genetics
    • Lack of emotional flexibility
    People who face certain stressors like medical problems or living in challenging environments may be at greater risk.
    The stressor itself may also interfere with an individual’s support network.
    Certain early-childhood family history factors seem to increase the chance that a person may suffer from an adjustment disorder in the future. These include:
    • Frequent moves as a child
    • Abusive family
    • Overprotective family
    • Coming from a disadvantaged background
    • Prior exposure to extreme trauma, such as war, without having previously developed either an adjustment disorder or post-traumatic stress disorder (PTSD)
    Individuals who are at higher risk for adjustment disorders often have other conditions, such as a history of anxiety, depression, bipolar disorder, or eating disorders.


    Adjustment disorder symptoms are expected to begin within 3 months and may disappear within 6 months after the causing stressor and/or its results have been removed. In the case of chronic adjustment disorder, the symptoms may last longer than 6 months. In general, they are related to ongoing persistent stressors like a chronic medical disability.
    Symptoms may vary, but are similar in that the reaction to the stressor is worse or more excessive than expected. In order for a diagnosis of adjustment disorder to be made, symptoms must interfere with an individual’s social or work functioning.
    Symptoms include:
    • Depressed or fixed mood, sadness
    • Difficulty breathing
    • Chest pain
    • Anxiety or worry
    • Feeling of inability to cope
    • Feeling of inability to plan ahead
    • Feeling of inability to continue in present situation
    • Some degree of disability in the performance of daily routine
    • Conduct disorders
    • Disturbance of other emotions and conduct
    Physical Symptoms of Anxiety
    Physical reaction anxiety
    Copyright © Nucleus Medical Media, Inc.


    An evaluation will be done. It will be used to assess whether your symptoms follow a recent stressful event, and if the symptoms are more severe than what is normal for you. You will also be evaluated to make sure there are no underlying disorders or disease, such as depression, an anxiety disorder, or post-traumatic stress disorder. You may be referred to a psychiatrist for diagnosis and treatment.


    The main goal of treatment is to resolve symptoms and return the person to a normal level of functioning. Treatment is important so that the disorder doesn’t become a larger illness, like major depression. Treatment options include:


    Psychotherapy, cognitive behavioral therapy, or counseling are the primary treatments for adjustment disorders. Therapy is used to help people understand why the stressful event caused the symptoms. It also helps develop coping mechanisms for future stressors. Therapy is generally short-term and can take any of the following forms:
    • Individual
    • Family
    • Behavioral
    • Group


    Medications may be used in combination with therapy to ease common symptoms. They are generally prescribed on a short-term basis until the symptoms resolve.
    Medications may treat:
    • Depression
    • Anxiety
    • Insomnia


    While there is no known way to prevent adjustment disorders, the prognosis is good. Adjustment disorders generally resolve with treatment and time.


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

    Substance Abuse and Mental Health Services Administration http://www.samhsa.gov


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

    Health Canada http://www.hc-sc.gc.ca


    Acute stress disorder. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114321/Acute-stress-disorder. Updated November 11, 2015. Accessed September 26, 2016.

    Bichitra N, Siddharth S. Adjustment disorder: current diagnostic status. Indian J Psychol Med. 2013 Jan-Mar; 35(1): 4–9.

    Carta MG, Balestrieri M, Murru A, Hardoy MC. Adjustment Disorder: Epidemiology, diagnosis and treatment. Clin Pract Epidemiol Ment Health. 2009;5:15.

    Casey P. Adult adjustment disorder: A review of its current diagnostic status. Journal of Psychiatric Practice. 2001;7(1):32-40.

    Kocalevent RD, Mierke A, et al. Adjustment disorders as a stress-related disorder: A longitudinal study of the associations among stress, resources, and mental health. PLoS One. 2014;9(5):e97303.

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