Adjustment Disorders

An adjustment disorder is a syndrome in which the patient experiences psychological and sometimes physical symptoms as a result of a stressful life event. While anyone might be expected to have reactions to a stressor, such as the death of a loved one or a divorce, when the reaction is extreme and interferes with normal functioning for an extended period of time, it is designated an adjustment disorder.

Causes of Adjustment Disorders

Adjustment disorders may affect individuals of any age since stressors occur at all life stages. The stressors, however, may differ. Being teased at at school, for example, may be a serious stressor for children or adolescents, while financial worries are more likely to affect adults, at least before such concerns affect lifestyle. Some of the most common stressors, any of which, alone or in combination, may precipitate an adjustment disorder, include:

  • Death of a loved
  • Divorce or serious relationship problems
  • Illness of oneself or of a loved one
  • Moving, particularly to another region
  • Financial difficulties
  • Catastrophes, such as fire or flood
  • Serious familial conflicts
  • Difficulties in school or workplace
  • Issues with one’s sexuality
  • Being the victim of a crime
  • Suffering severe injury

While there is no precise way to predict who will develop an adjustment disorder, psychological instability and poor social skills may be risk factors.

Symptoms of Adjustment Disorders

Adjustment disorders may manifest in both psychological and physical symptoms.

Psychological Symptoms of Adjustment Disorders

Psychological symptoms of an adjustment disorder may include any type of emotional distress. Patients suffering from the condition may:

  • Cry a great deal
  • Express sadness or depression
  • Be nervous, irritable, or anxious
  • Experience loss of appetite or eat excessively
  • Act defiantly, impulsively or recklessly
  • Abuse alcohol or other substances
  • Withdraw from relationships or social situations
  • Express suicidal thoughts or, in extreme cases, attempt suicide

Physical Symptoms of Adjustment Disorders

Physical symptoms of adjustment disorders may vary widely. Patients may experience:

  • Palpitations
  • Extreme fatigue
  • Headache or stomachache
  • Body aches
  • Twitching
  • Trembling
  • Sleep disturbances

What distinguishes these thoughts and behaviors from more normal reactions to extreme stress is that they are severe and ongoing, and interfere with normal functioning at home, at school, or in the workplace. In order to be diagnosed with an adjustment disorder, symptoms must arise within three months of a traumatic event and the patient must be shown not be suffering with another diagnosable disorder.

Diagnosis of Adjustment Disorders

Primary care doctors, psychologists, teachers, counselors or social workers may suspect an adjustment disorder, but such cases should always be referred to a psychiatrist for diagnosis confirmation. The psychiatrist will then be able to prescribe any necessary medication and recommend other appropriate treatment. A distinction is made between an adjustment disorder and post-traumatic stress disorder (PTSD), a syndrome of much greater duration.

Treatments for Adjustment Disorders

Adjustment disorders are treated both with medication and psychotherapy. Patients are typically treated for symptom relief in the hope of returning them to their normal level of functioning. In most cases, medication is prescribed to help the patient feel well enough to engage in productive psychotherapy. Psychotherapy, or talk therapy, is designed to assist the patient in recognizing and altering destructive responses to stress so psychological stability can be re-established. Types of psychotherapy that may be employed to treat adjustment disorders may include:

  • Cognitive behavioral therapy
  • Family therapy
  • Self-help groups, such as bereavement groups

Treatment of adjustment disorders is normally quite successful, unless the stressor continues unabated. If a patient has become homeless, for example, until a new comfortable living situation is found the symptoms may continue. In most cases, adjustment disorders resolve in about six months as the patient adapts, with or without treatment, to the new life situation.

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