ADJUSTMENT DISORDERS

Overview

Change, transition and stress are a part of life. Sometimes highly stressful events affect our ability to cope. When these stressors result in significant negative changes to our thoughts, emotions and behaviours, and affect how we function in our daily lives, we may be experiencing an adjustment disorder. 

What is an adjustment disorder? 

Adjustment disorders are psychological conditions that occur when a person has significant, negative emotional or behavioural symptoms that emerge within 3 months of a stressful life event. Symptoms are often expressed differently in different people.

Symptoms may include: 

• Crying more than usual

• Changes in mood such as experiencing ongoing sadness, irritability and/ or hopelessness

• Feeling anxious and excessive worrying

• Difficulty with sleep

• Significant changes in appetite

• Social withdrawal (not wanting to see friends or family)

• Difficulty with concentration, focus and memory

• High risk behaviours

• Thoughts of self-harm or suicide 

What triggers an adjustment disorder?

A stressful event or series of events can trigger significant changes to our thoughts, emotions and behaviours. Some

examples of stressors are:

• Changes to intimate relationships such a divorce, having a baby or infidelity. 

• Significant work or school stress

• Relocating cities or countries

• Changes in health or a medical diagnosis

• Financial stress

• Natural disasters

Diagnosing adjustment disorders

To be diagnosed with Adjustment Disorder, The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) specifies that one or both of the following criteria must be met: 

• Distress that is greater than expected in relation to the stressor

• Symptoms cause marked impairment and distress in every day functioning

In order to confirm a diagnosis, it is important to establish that the new symptoms are not part of an existing mental health disorder or part of a normal grieving process. 

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Symptoms emerge within 3 months of experiencing the stressful event and resolve within 6 months of the end of the stressful event. 

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What is the difference between adjustment disorders and PTSD?

Both adjustment disorders and post-traumatic stress disorder occur after a stressful event and impact a person’s ability to cope. Events that trigger PTSD are typically life-threatening and more severely distressing, for example, violent assaults, traumatic injury or war. A characteristic symptom of PTSD is experiencing flashbacks, which do not usually occur with adjustment disorders.

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How common are adjustment disorders? 

Data is varied but some global studies estimate that 2% of the population suffer from adjustment disorders.

Who can experience adjustment disorders? 

Anyone can experience an adjustment disorder, including children. Some factors may increase the risk of experiencing an adjustment disorder such as genetics, family history, personality and life experiences. 

When do I seek help? 

Often symptoms resolve once the stressful event is over. However, if you are having ongoing difficulties managing day to day functioning, or any thoughts of self-harm or suicide, talking to a mental health professional can help. 

Complications

Adjustment disorders are short-term conditions, but if they do not resolve they can lead to longer-term mental health issues such as mood or anxiety disorders, or substance abuse disorders.

How does treatment help? 

Talking to a psychologist can be beneficial in understanding your reaction to the stressful events in your life. They can help by providing you with a safe place to talk through your reactions and can assist you in finding better ways to cope. 

Sometimes medication may be suggested as a useful addition to psychological therapy. 

References

1. Mayo Clinic. Adjustment disorders [Internet]. 06/07/2023. Available from: https://www.mayoclinic.org/diseases-conditions/adjustment-disorders/symptoms-causes/syc-20355224