DefinitionAdjustment disorder is a group of symptoms, such as stress, feeling sad or hopeless, and physical symptoms that can occur after you go through a stressful life event.The symptoms occur because you are having a hard time coping, and the reaction is stronger or greater than what would be expected for the type of event that occurred.
Causes, incidence, and risk factorsMany different events may trigger symptoms of an adjustment disorder. Whatever the trigger is, the event may become too much for you.Stressors for people of any age include:Death of a loved oneDivorce or problems with a relationshipGeneral life changesIllness or other health issues in yourself or a loved oneMoving to a different home or a different cityUnexpected catastrophesWorries about moneyTriggers of stress in teenagers and young adults may include:Family problems or conflictSchool problemsSexuality issuesThere is no way to predict which people who are affected by the same stress are likely to develop adjustment disorder. Your social skills before the event, and how you have learned to deal with stress in the past may play roles.
SymptomsSymptoms of adjustment disorder are often severe enough to affect work or social life. Some of the symptoms include:Acting defiant or showing impulsive behaviorActing nervous or tenseCrying, feeling sad or hopeless, and possibly withdrawing from other peopleSkipped heartbeats and other physical complaintsTrembling or twitchingTo have adjustment disorder, you must meet the following criteria:The symptoms clearly come after a stressor, most often within 3 monthsThe symptoms are more severe than would be expectedThere do not appear to be other disorders involvedThe symptoms are not part of normal grieving for the death of a loved oneOn occasion, symptoms can be severe and the person may have thoughts of suicide or make a suicide attempt.
TreatmentThe main goal of treatment is to relieve symptoms and help you return to a similar level of functioning as before the stressful event occurred.Most mental health professionals recommend some type of talk therapy. This type of therapy can help you identify or change your responses to the stressors in your life. Cognitive behavioral therapy (CBT) can help you deal with your feelings.First your therapist helps you recognize the negative feelings and thoughts that occur.Then your therapist teaches you how to change these into helpful thoughts and healthy actions.Other types of therapy may include: Long-term therapy, where you will explore your thoughts and feelings over many months or moreFamily therapy, where you will meet with a therapist along with your familySelf-help groups, where the support of others may help you get betterMedicines may be used, but only along with some type of talk therapy. These medicines may help if you are:Nervous or anxious most of the timeNot sleeping very wellVery sad or depressed
Expectations (prognosis)With the right help and support, you should get better quickly. The problem usually does not last longer than 6 months, unless the stressor continues to be present.
Calling your health care providerCall for an appointment with your health care provider if you develop symptoms of adjustment disorder.
ReferencesPowell AD. Grief, Bereavement, and adjustment disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 38.