Adjustment Disorder

Major life changes, such as the death of a loved one, relationship changes, or moving to a new city, can cause stress. Most people get used to changes within a few months. However, for some people, coping with the sadness, hopelessness, and stress associated with change becomes overwhelming.

Adjustment disorders or situational depression are a type of short-term, stress-related mental illness that can occur in some people after a major life event.

Causes

The type of stress that can trigger adjustment disorder varies from person to person, but can include:

  • Divorce

  • Job loss or job change

  • Difficult circumstances

  • Developing a serious illness

  • Serious illness in a loved one

  • Being the victim of a crime

  • Having an accident

  • Having a big life change - getting married, having a baby or retiring

  • Living through a natural disaster such as fire, flood or tornado

  • Money worries

Triggers of stress in adolescents and young adults can be:

  • Family problems or conflicts

  • School problems

  • Sexuality issues

Since people differ in their responses to stress, there is no way to predict who can develop an adjustment disorder. Those who cannot cope with changes or do not have a good support system may have a higher risk of developing adjustment disorders.

Signs and symptoms

The symptoms of an adjustment disorder are similar to depression and can be severe enough to affect work, school or social life. Symptoms of an adjustment disorder include:

  • Frequent crying

  • Anxiety and worry

  • Body aches of unknown explanation

  • Palpitations (an unpleasant sensation of irregular or forceful beating of the heart)

  • Problems sleeping

  • Fatigue

Signs of an adjustment disorder include:

  • Defiant, impulsive, or destructive behavior

  • Absence from work or school

  • Withdrawal or isolation from people and social activities

  • Changes in appetite, either loss of appetite or overeating

  • Increase in the use of alcohol or other drugs

  • Trembling or twitching

To be diagnosed with adjustment disorder, the symptoms:

  • Are the result of a life change, usually occurring within three months of the event

  • Are more severe than would be expected

  • Are only related to adjustment disorder without other mental health disorders involved

  • Are not part of normal grieving for the death of a loved one

Some people who have severe cases of adjustment disorder may have thoughts of suicide or make a suicide attempt.

Diagnosis

After you have ruled out a physical illness, your health care provider may refer you to a mental health assessment to determine your behavior and symptoms.

Types of adjustment disorders are:

  • Adjustment disorder with depressed mood. Symptoms mainly include feeling sad, tearful and hopeless, and experiencing a lack of pleasure in the things you used to enjoy.

  • Adjustment disorder with anxiety. Symptoms mainly include nervousness, worry, difficulty concentrating or remembering things, and feeling overwhelmed. Children who have adjustment disorder with anxiety may strongly fear being separated from their parents and loved ones.

  • Adjustment disorder with mixed anxiety and depressed mood. Symptoms include a mix of depression and anxiety.

  • Adjustment disorder with disturbance of conduct. Symptoms mainly involve behavioral problems, such as fighting, reckless driving or ignoring your bills. Youths may skip school or vandalize property.

  • Adjustment disorder with mixed disturbance of emotions and conduct. Symptoms include a mix of depression and anxiety as well as behavioral problems.

  • Unspecified adjustment disorder. Symptoms don't fit the other types of adjustment disorders, but often include physical problems, problems with family or friends or work or school problems.

Treatment

In cognitive-behavioral therapy (CBT), individuals learn how to break out of the vicious cycle of negative thoughts. The therapist helps the client recognize negative thoughts and feelings and their effects. Then, the therapist teaches the client to use negative thoughts as cues for helpful thoughts and healthy actions.

Medications may be recommended. With the right help and support, patients with adjustment disorders will quickly improve.

CHI Health Psychiatric Associates, with offices in Omaha and surrounding areas, has highly-trained mental health providers who can address the needs of those who suffer from an adjustment disorder. If you think you or a loved one may be suffering from an adjustment disorder, call (402) 717-HOPE.