What Is an Adjustment Disorder?

Adjustment disorder is a condition that negatively impacts someone’s mental health and wellbeing. This relatively common mental disorder develops in response to stressors; when events or life crises exceed someone’s ability to effectively cope, an adjustment disorder may occur. Just what is an adjustment disorder?

Definition of Adjustment Disorder

An adjustment disorder is defined by two important concepts:

1. the presence of an identifiable stressor and emotional or behavioral symptoms that occur in response to the stressor (American Psychiatric Association, 2013).
2. Further, the reaction to the stressor exceeds an expected stress response.

Everyone faces stress and can experience negative reactions, but when someone struggles to adjust to and cope with the stressor, an adjustment disorder may be diagnosed. Adjustment disorders often develop when stressors exceed the resources someone has to deal with them.

Adjustment disorders are typically time-limited. When the stressor is removed or the person has adjusted to it, the diagnosis no longer applies. If this occurs within six months of the onset of the stressor, the adjustment disorder is considered acute. Sometimes, if a stressor is ongoing, an adjustment disorder can last beyond six months. When this happens, it becomes chronic adjustment disorder.

Types of Adjustment Disorders

All adjustment disorders are precipitated by stressors. One or more events occur to derail someone, decrease his/her mental health and wellbeing, and disrupt his/her life. How each person responds to the stress determines how his/her adjustment disorder is categorized.

Adjustment disorders are organized into subtypes according to specific symptoms. The categories include adjustment disorder with

• Adjustment disorder with depressed mood
• Adjustment disorder with Anxiety
• Adjustment disorder with mixed depressed mood and anxiety
• Adjustment disorder with disturbance of conduct

Occasionally, when someone’s symptoms don’t fall into one specific category, the adjustment disorder is considered unspecified.

Types of Stressors That Lead to an Adjustment Disorder

Many different types of stressors can cause adjustment disorders. Among them are:

• External events such as relationship difficulties, financial problems
• Life transitions such as marriage, parenthood, relocating
• Developmental transitions such as going to school, leaving home, retirement
• Situational crises such as the death of a loved one, losing a job, serious physical illness
• Microstresses, little daily stressors that accumulate over time

By themselves, any of these stressors do not lead to an adjustment disorder. Adjustment disorder comes from someone’s reaction to the stress rather than to the stress itself.

Risk Factors for Adjustment Disorders

Stress is an unavoidable part of the human condition, and everyone responds negatively to stressors from time-to-time. Certain factors make some people more susceptible to adjustment disorders.

When a stressor triggers an area in which someone is vulnerable or sensitive, he/she may be more at risk of an adjustment disorder. If someone already lives with a mental illness or personality disorder, he/she may be more likely to develop an adjustment disorder.

Further, because of the chronic nature of these stressors, the following circumstances are risk factors for adjustment disorders:

• Poverty
• Limited support systems
• Childhood trauma, abuse, family disruptions/conflict
• Life-threatening illness
• Substance use/abuse
• Multiple unresolved stressors

Impact of Adjustment Disorder

Adjustment disorders are found in all cultures and in all age groups. It’s estimated that they affect 5-20 percent of people in outpatient treatment and up to 50 percent of people in hospital settings (American Psychiatric Association, 2013).

Most adjustment disorders are temporary and situational; however, they can cause extreme distress and sometimes lead to suicidal ideation and behavior. They can negatively impact all aspects of someone’s life: work, social life, home and family life, and more. Therefore, they must be taken seriously and properly treated. With treatment, adjustment disorders diminish and people can regain positive mental health.

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