Adjustment disorder is a short-term condition that occurs when a person has great difficulty coping with, or adjusting to, a particular source of stress, such as a major life change, loss, or event. In 2013, the mental health diagnostic system technically changed the name of "adjustment disorder" to "stress response syndrome."
Because people with an adjustment disorder/stress response syndrome often have some of the symptoms of clinical depression, such as tearfulness, feelings of hopelessness, and loss of interest in work or activities, adjustment disorder is sometimes informally called "situational depression." Unlike major depression, however, an adjustment disorder doesn't involve as many of the physical and emotional symptoms of clinical depression (such as changes in sleep, appetite and energy) or high levels of severity (such as suicidal thinking or behavior).
The type of stress that can trigger an adjustment disorder/stress response syndrome varies depending on the person, but can include:
- Ending of a relationship or marriage
- Losing or changing job
- Death of a loved one
- Developing a serious illness (yourself or a loved one)
- Being a victim of a crime
- Having an accident
- Undergoing a major life change (such as getting married, having a baby, or retiring from a job)
- Living through a disaster, such as a fire, flood, or hurricane
A person with an adjustment disorder/stress response syndrome develops emotional and/or behavioral symptoms as a reaction to a stressful event. These symptoms generally begin within three months of the event and rarely last for longer than six months after the event or situation has ended. In an adjustment disorder, the reaction to the stressor is greater than what is typical or expected for the situation or event. In addition, the symptoms may cause problems with a person's ability to function; for example, the person may be have trouble with sleep, work, or studying.
An adjustment disorder/stress response syndrome is not the same as post-traumatic stress disorder (PTSD). PTSD occurs as a reaction to a life-threatening event that occurs at least 1 month after the event, and its symptoms tend to last longer than in adjustment disorders/stress response syndromes. By comparison, adjustment disorders/stress response syndromes rarely last longer than six months.
What Are the Symptoms of an Adjustment Disorder/Stress Response Syndrome?
An adjustment disorder/stress response syndrome can have a wide variety of symptoms that are changes from someone's usual self, which may include:
- Feeling of hopelessness
- Frequent crying
- Anxiety (nervousness)
- Headaches or stomachaches
- Palpitations (an unpleasant sensation of irregular or forceful beating of the heart)
- Withdrawal or isolation from people and social activities
- A new pattern of absence from work or school
- New and uncharacteristic dangerous or destructive behavior, such as fighting, reckless driving, and vandalism
- Changes in appetite, either loss of appetite, or overeating
- Problems sleeping
- Feeling tired or without energy
- Increase in the use of alcohol or other drugs
Symptoms in children and teens tend to be more behavioral in nature, such as skipping school, fighting, or acting out. Adults, on the other hand, tend to experience more emotional symptoms, such as sadness and anxiety.
How Common Is an Adjustment Disorder/Stress Response Syndrome?
Adjustment disorder/stress response syndrome is very common and can affect anyone, regardless of gender, age, race, or lifestyle. Although an adjustment disorder can occur at any age, it is more common at times in life when major transitions occur, such as adolescence, mid-life, and late-life.
How Do I Find Out if I Have an Adjustment Disorder/Stress Response Syndrome?
If you suspect you may have an adjustment disorder/stress response syndrome, see your doctor. If symptoms are present, your doctor may perform a physical exam and ask questions about your medical and mental health history. Although there are no imaging or lab tests to specifically diagnose an adjustment disorder, the doctor may sometimes use laboratory tests -- such as blood tests or imaging studies like CT or MRI scans -- to rule out physical illness or other medical causes of changes in mood or behavior (such as head trauma) as the cause of your symptoms. Your doctor will also look for other mental illnesses, such as post-traumatic stress disorder, major depression, or an anxiety disorder.
Your doctor bases his or her diagnosis of adjustment disorder/stress response syndrome on your report of the intensity and duration of symptoms -- including any problems with daily functioning caused by the symptoms. In general, an adjustment disorder/stress response syndrome is suspected if the level of distress is more intense than would normally be expected, given the stressor, or if the symptoms interfere with normal functioning.
If adjustment disorder/stress response syndrome is suspected, your doctor will likely refer you to a psychiatrist, psychologist, or other mental health professional who are trained to help people when they have trouble coping with and managing stressful life events.
How Is an Adjustment Disorder/Stress Response Syndrome Treated?
Psychotherapy (a type of counseling) is the most common treatment for adjustment disorder/stress response syndrome. Therapy helps the person understand how the stressor has affected his or her life. It also helps the person develop better coping skills. Support groups can also be helpful by allowing the person to discuss his or her concerns and feelings with people who are coping with the same stress. In some cases, short-term medication may be used to help control anxiety symptoms or sleeping problems.
If you have symptoms of adjustment disorder/stress response syndrome, it is very important that you seek medical care. Adjustment disorders also can sometimes turn into major depressive episodes in people who are at risk for developing mood disorders. Plus, you may develop a substance abuse problem if you turn to alcohol or drugs to help you cope with stress and anxiety.
Most people with adjustment disorder/stress response syndrome recover completely. In fact, a person who is treated for adjustment disorder/stress response syndrome may learn new skills that actually allow him or her to function better than before the symptoms began.
Can an Adjustment Disorder/Stress Response Syndrome Be Prevented?
There is no known way to prevent adjustment disorder/stress response syndrome. However, strong family and social support can help a person work through a particularly stressful situation or event. The best prevention is early treatment, which can reduce the severity and duration of symptoms, and teach new coping skills.