Adjustment disorder (AjD) is an emotional and behavioral disorder that’s diagnosed when stressful times in life from expected or unexpected events cause an individual to be confused and lost (disoriented). Adjustment disorder indicates a maladaptive response to stress that prevents an individual from going on with normal, everyday life. Some of the instances that may cause an individual stress include losing a job and not knowing how to pay the mortgage on the house, having been cheated on by a spouse, or being the victim of a sexual assault. Prior to 1980, the American Psychiatric Association called adjustment disorder a “transient situational disturbance”.

Stressors That May Cause Adjustment Disorder DSM-5

A stressor can be a single event, such as:

  • Divorce or breakup of a relationship
  • Being fired from a job
  • Grief and loss

There may be multiple stressors, including:

  • Business difficulties and marital problems

Stressors may be recurrent, such as:

  • Business crises 
  • Unfulfilling sexual relationships

Continuous stressors can include:

  • Chronic illness that increases disability
  • Residing in a crime-filled community
  • Bereavement

Some stressors can affect an entire family or community, such as:

  • A natural disaster
  • Terrorism

Some of the stressors can accompany specific developmental events, such as:

  • Getting married
  • Going to school
  • Becoming a parent
  • Leaving the parents’ home
  • Re-entering the parents’ home after being away (such as having been at college, after a marriage or relationship breakup, or loss of a job)
  • Failure to succeed in a career
  • Retirement

Adjustment Disorder Criteria 

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) defines adjustment disorder as “the presence of emotional or behavioral symptoms in response to an identifiable stressor/s, which occurred within three months of the beginning of the stressor/s.” Criteria for adjustment disorder include one or both of the following:

  • Distress that’s out of proportion with the expected reactions to the stressor.
  • Symptoms must be clinically significant. They cause severe distress and impairment in functioning.

In addition, the following criteria must be present:

  • The distress and impairment are related to the stressor and not because of an intensification of existing mental health disorders.
  • The reaction isn’t part of normal bereavement.
  • When the stressor is removed or the individual has begun to adjust and cope, the symptoms subside within six months of the onset of the stressor.

Signs of Adjustment Disorder DSM-5

Symptoms can show for a single event or continually stressful circumstances. The usual stressors are interruptions in close relationships except for bereavement; events that disrupt adjustment, such as disasters; and job failure or loss. Symptoms include:

  • Low mood
  • Worry
  • Insomnia
  • Sadness
  • Difficulty concentrating
  • Anxiety
  • Angry or disruptive behavior
  • Loss of self-esteem
  • Hopelessness
  • Feeling trapped and out of options
  • Feeling isolated
  • Substance abuse

Children and adolescents typically show the following symptoms in adjustment disorder:

  • Irritability
  • Depression
  • Poor sleep
  • Poor grades and performance in school

What Is the Recommended Treatment for Adjustment Disorder?

Psychotherapy is usually the best choice for adjustment disorder, because the disorder is seen as temporary and a somewhat normal reaction to a stressful event. The therapist works with the individual to find more adaptive emotions and conduct, helping them deal more effectively with the problem. In addition, the therapist helps the individual find a clearer understanding of the issue/s causing depression and anxiety. The treatment will often emphasize the significance of social support in the individual’s life. If there’s an issue with stress, therapy may also include relaxation training and techniques.

While adjustment disorder rarely extends beyond six months, there may be some lasting anxiety and depressed mood that happens beyond that time frame. That is normal and usually not serious enough to require additional treatment.

Family therapy may be ideal for particular individuals, which is especially important if the person is an adolescent. This is the appropriate therapy if the family is using a family member as a scapegoat (blaming that individual). Sometimes, family members identify a person as the one with the problem, although the issue is family-related. The family members can be educated about the disorder and gain knowledge of its seriousness.

When the disorder is negatively affecting a marriage or romantic relationship, couples therapy may be ideal. 

What Are Some Self-Care Tips for Adjustment Disorder?

In addition to seeing a therapist or counselor, it’s also important to take care of yourself: Get plenty of exercise, follow a nutritional diet, and maintain a regular schedule that includes sufficient sleep. Keeping a journal in order to write down feelings is often helpful, as well as indulging in creative activities, such as art and music. Many people feel that volunteering in an animal shelter, serving meals for those in need, and other causes help them to feel more positive. In addition, the following suggestions may also help to improve a person’s state of mind and cope better with the disorder:

  • Avoid unnecessary stress. If you’re going to start a new job soon, don’t add other things to your to-do list. Additional responsibilities may make you even more anxious. If there’s anything you can hold off from doing right away, it would be ideal to put it on the backburner so that you can focus on what is most important now.
  • Start a healthy habit. Healthy means more than just nutrition in your diet. Healthy habits are also for the mind, and there’s no time like the present to do something that will help you think positively. You can keep a journal to log your thoughts or join a gym and relieve some of the stress. Yoga and jogging are also great stress relievers.
  • Take advantage of the social support in your life. Family and friends are critical when you’re feeling high levels of stress or going through changes in your life. There’s nothing like visiting with a good friend who is there for you. You can join family members for dinner, watch movies, or take a hike. It may feel good to talk about your anxieties with those close to you. 
  • Join a support group. Sometimes it helps to share your frustrations and anxieties with other people who’ve been through the same types of situations. By hearing their stories, you may find that you don’t feel quite so alone. They can also be an inspiration. In the process, you may make some new friends.

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