Definition

Adjustment disorder is an emotional or behavioral response to a stressful event, such as a divorce or natural disaster. These symptoms are more severe than they should be. This can make it hard to return to normal day-to-day life.

Causes

Adjustment disorder is caused by stress or changes in a person's life. Genes and past stressful events may also play a role.

Risk Factors

Things that may raise the risk of this problem are:

  • Current or past history of other mental health problems, such as posttraumatic stress disorder
  • Problems within a person's family
  • Having a poor support system
  • Major life changes and stress in childhood

Any stressful event can lead to an adjustment disorder. Some examples are:

  • School challenges
  • Loss of work or retirement
  • Illness
  • Death of loved ones
  • Major life change, such as marriage, divorce, baby, or moving
  • Being in the military or going to war
  • Natural or other widespread disasters

Symptoms

Adjustment disorder starts within 3 months of the event. It can last up to 6 months or more after the stress is gone. Problems can vary but may be:

  • Feeling sad and hopeless
  • Loss of motivation and self-esteem
  • Having a hard time finding pleasure in things that the person used to enjoy
  • Frequent crying
  • Feel overwhelmed easily
  • Excess worry
  • Feeling that nothing will work out well
  • Bursts of anger
  • Drug or alcohol misuse
  • Fighting or seeking revenge
  • Problems with relationships, school, or work

Diagnosis

The doctor will ask about your symptoms and health history. You may also be asked about any major changes or problems in daily life. A physical exam may be done. This is often enough to make the diagnosis.

Treatment

Treatment can help to ease the impact of the stress. This may lower the effect on day to day life. Choices are:

  • Mental health counseling to learn about stress and how to cope
  • Medicines to ease some symptoms

Prevention

There are no guidelines to prevent this health problem.

RESOURCES:

American Psychiatric Association
https://www.psychiatry.org

National Institute of Mental Health
https://www.nimh.nih.gov

CANADIAN RESOURCES:

Canadian Mental Health Association
https://cmha.ca

Canadian Psychiatric Association
https://www.cpa-apc.org

REFERENCES:

Adjustment disorder. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/adjustment-disorder. Accessed November 18, 2020.

Adjustment disorder. Johns Hopkins Psychiatry Guide. Available at: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787068/all/Adjustment_Disorder. Accessed November 18, 2020.

Adjustment disorders. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/psychiatric-disorders/anxiety-and-stressor-related-disorders/adjustment-disorders. Accessed November 18, 2020.

Bachem R, Casey P. Adjustment disorder: A diagnosis whose time has come. J Affect Disord. 2018 Feb;227:243-253.

Sundquist J, Ohlsson H, et al. Common adult psychiatric disorders in Swedish primary care where most mental health patients are treated. BMC Psychiatry. 2017;17(1):235.

Last reviewed September 2020 by EBSCO Medical Review Board Adrian Preda, MD