Work problems, going away to school, an illness — any number of life changes can cause stress. Most of the time, people adjust to such changes within a few months. But if you continue to feel down or self-destructive, you may have an adjustment disorder.
An adjustment disorder is a type of stress-related mental illness. You may feel anxious or depressed, or even have thoughts of suicide. Your normal daily routines may feel overwhelming. Or you may make reckless decisions. In essence, you have a hard time adjusting to change in your life, and it has serious consequences.
You don’t have to tough it out on your own, though. Adjustment disorder treatment — usually brief — is likely to help you regain your emotional footing.
Adjustment disorders symptoms vary from person to person. The symptoms you have may be very different from those of someone else with an adjustment disorder. But for everyone, symptoms of an adjustment disorder begin within three months of a stressful event in your life.
Signs and symptoms of adjustment disorder may affect how you feel and think about yourself or life, including:
Signs and symptoms of adjustment disorder may affect your actions or behavior, such as:
How long you have symptoms of an adjustment disorder also can vary:
Sometimes the stressful change in your life goes away, and your symptoms of adjustment disorder get better on their own. But often, the stressful event remains a part of your life. Or a new stressful situation comes up, and you face the same emotional struggles all over again.
You may think that an adjustment disorder is less serious than other mental health problems because it involves stress, but that’s not necessarily true. Adjustment disorders can affect your whole life. You may feel so overwhelmed, stressed and hopeless that you can’t go about your normal daily activities. You may skip work or school, for instance, or not pay your bills. You may drive dangerously or pick fights.
Talk to your doctor if you’re having trouble getting through each day. You can get treatment to help you cope better with stressful events and feel better about life again.
If you or someone you love has suicidal thoughts, seek help immediately.
People of all ages are affected by adjustment disorders. Among children and teenagers, both boys and girls have about the same chance of having adjustment disorders. Among adults, women are twice as likely to have adjustment disorders. But researchers are still trying to figure out what causes adjustment disorders. As with other mental disorders, the cause is likely complex and may involve genetics, your life experiences, your temperament and even changes in the natural chemicals in the brain.
Although the cause of adjustment disorders is unknown, some things make you more likely to have an adjustment disorder.
One or more stressful life events may put you at risk of developing an adjustment disorder. It may involve almost any type of stressful event in your life. Both positive and negative events can cause extreme stress. Some common examples include:
In some cases, people who face an ongoing stressful situation — such as living in a crime-ridden neighborhood — can reach a breaking point and develop an adjustment disorder.
If you generally don’t cope well with change or you don’t have a strong support system, you may be more likely to have an extreme reaction to a stressful event.
Your risk of an adjustment disorder may be higher if you experienced stress in early childhood. Overprotective or abusive parenting, family disruptions, and frequent moves early in life may make you feel like you’re unable to control events in your life. When difficulties then arise, you may have trouble coping.
Other risk factors may include:
Most adults with adjustment disorder get better within six months and don’t have long-term complications. However, people who also have another mental health disorder, a substance abuse problem or a chronic adjustment disorder are more likely to have long-term mental health problems, which may include:
Compared with adults, teenagers with adjustment disorder — especially chronic adjustment disorder marked by behavioral problems — are at significantly increased risk of long-term problems. In addition to depression, substance abuse and suicidal behavior, teenagers with adjustment disorder are at risk of developing psychiatric illnesses such as:
If you have thoughts of suicide, go to an emergency room or call 911 or your local emergency number immediately.
If you have less urgent symptoms of an adjustment disorder, make an appointment with your family doctor. While adjustment disorders resolve on their own in most cases, your doctor may be able to recommend coping strategies or treatments that may help you feel better sooner.
Here’s some information to help you prepare for your appointment, and what to expect from your doctor.
For adjustment disorder, some basic questions to ask your doctor include:
In addition to the questions that you’ve prepared to ask your doctor, don’t hesitate to ask questions during your appointment at any time that you don’t understand something.
Being ready to answer your doctor’s questions may save some time to go over any points you want to talk about in-depth. Your doctor may ask:
While you’re waiting for your doctor appointment, try reaching out to your friends or family. Talking about your feelings and asking for help is the most important thing you can do to aid your recovery from adjustment disorder.
If your child has symptoms of an adjustment disorder, try gently encouraging him or her to talk about feelings. Many parents assume that talking about a difficult change, such as divorce, will only make a child feel worse. But the opposite is true. Your child needs the opportunity to express feelings of grief, and to hear your reassurance that you’ll remain a constant source of love and support.
Adjustment disorders are diagnosed based on signs and symptoms and a thorough psychological evaluation. To be diagnosed with adjustment disorder, someone must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment.
For an adjustment disorder to be diagnosed, several criteria must be met, including:
Most people find treatment of adjustment disorder helpful, and they often require treatment only briefly. Others may benefit from longer treatment, though. There are two main types of treatment for adjustment disorder — psychotherapy and medications.
The main treatment for adjustment disorders is psychotherapy, also called counseling or talk therapy. You may attend individual therapy, group therapy or family therapy. Therapy can provide emotional support and help you get back to your normal routine. It can also help you learn why the stressful event affected you so much. As you understand more about this connection, you can also learn healthy coping skills. These skills can help you deal with other stressful events that may arise in your life.
In some cases, medications may help, too. Medications can help with such symptoms as depression, anxiety and suicidal thoughts. Antidepressants and anti-anxiety medications are the medications most often used to treat adjustment disorders. As with therapy, you may need medications only for a few months.
When you face a stressful event or major life change, you can take some steps to care for your emotional well-being. Do what works for you. For example:
If it’s your child who’s having difficulty adjusting, take these steps to help:
If you use these kinds of self-care steps but they don’t seem to be helping, be sure to talk to your doctor.
There are no guaranteed ways to prevent adjustment disorder. But developing healthy coping skills and learning to be resilient may help you during times of high stress. Resilience is the ability to adapt well to stress, adversity, trauma or tragedy. Some of the ways you can improve your resilience are:
If you know that a stressful situation is coming up — such as a move or retirement — call on your inner strength in advance. Remind yourself that you can get through it. Use stress management and coping skills, such as exercise, yoga, meditation or even a night at the movies with friends. In addition, consider checking in with your doctor or mental health provider to review healthy ways to manage your stress.