Adjustment Disorders Health Article

Definition

An adjustment disorder is a debilitating reaction, usually lasting less than six months, to a stressful event or situation. It is not the same thing as post-traumatic stress disorder (PTSD), which usually occurs in reaction to a life-threatening event and can be longer lasting.

Description

An adjustment disorder usually begins within three months of a stressful event, and ends within six months after the stressor stops. There are many different subtypes of adjustment disorders, including adjustment disorder with:

• depression
• anxiety
• mixed anxiety and depression
• conduct disturbances
• mixed disturbance of emotions and conduct
• unspecified

Adjustment disorders are very common and can affect anyone, regardless of gender, age, race, or lifestyle. By definition, an adjustment disorder is short-lived, unless a person is faced with a chronic recurring crisis (such as a child who is repeatedly abused). In such cases, the adjustment disorder may last more than six months.

Causes and symptoms

An adjustment disorder occurs when a person can't cope with a stressful event and develops emotional or behavioral symptoms. The stressful event can be anything: it might be just one isolated incident, or a string of problems that wears the person down. The stress might be anything from a car accident or illness, to a divorce, or even a certain time of year (such as Christmas or summer).

People with adjustment disorder may have a wide variety of symptoms. How those symptoms combine depend on the particular subtype of adjustment disorder and on the individual's personality and psychological defenses. Symptoms normally include some (but not all) of the following:

• hopelessness
• sadness
• crying
• anxiety
• worry
• headaches or stomachaches
• withdrawal
• inhibition
• truancy
• vandalism
• reckless driving
• fighting
• other destructive acts

Diagnosis

It is extremely important that a thorough evaluation rule out other more serious mental disorders, since the treatment for adjustment disorder may be very different than for other mental problems.

In order to be diagnosed as a true adjustment disorder, the level of distress must be more severe than what would normally be expected in response to the stressor, or the symptoms must significantly interfere with a person's social, job, or school functioning. Normal expression of grief, in bereavement for instance, is not considered an adjustment disorder.