Adjustment Disorder: When You Just Can’t Get Over It

Man with Depression and Adjustment DisorderThere’s a Japanese proverb: “Fall seven times, stand up eight.” But what if on one of those occasions, you don’t stand? What if the latest blow has left you unable to bounce back, as much as you may try? You may be dealing with a condition called adjustment disorder — also known by the names situational depression and stress response syndrome. In simple terms, it means an inability to cope with a life change, whether a one-time event such as a divorce, a job loss, or an unexpected catastrophe such as a fire or flood, or an ongoing one such as a marital, health or financial problem. While such situations naturally promote distress, an adjustment disorder is marked by a more extreme response than would normally be expected and can show itself through symptoms such as these:

  • A feeling of hopelessness
  • Trouble focusing or concentrating
  • A lack of enjoyment in things that once brought pleasure
  • Anxiety, tension, agitation and worry
  • Social withdrawal
  • Physical issues such as chest pains, stomachache, headache and general aches and pains
  • Sadness or tearfulness
  • Impulsivity
  • Reckless or disruptive conduct
  • Problems on the job/at school
  • Difficulty sleeping
  • Increased substance use
  • Thoughts of suicide

While adjustment disorder with depressed mood is common, adjustment disorder isn’t the same thing as clinical depression (also called major depressive disorder), which has more severe and long-term physical and emotional effects. However, if left untreated, major depression and mental health issues can become part of the diagnosis.

Signs of Adjustment Disorder

So how do you know if you have an adjustment disorder? One sign is that the emotional and behavioral symptoms of an adjustment disorder normally develop within three months of a stressful event. Symptoms also can’t be explained as part of bereavement. But the biggest clue is that the person’s reactions to the life stressor are out of proportion to the event. And it’s important to note that adjustment disorder can also happen as a result of what might be considered positive life changes, such as having a baby, getting married or starting a new job. For most, the symptoms last less than six months, but in some situations, they can last much longer and require professional help to overcome. Why some people develop an adjustment disorder in response to stress while others don’t isn’t well understood, but genetics, personality and environment are thought to play a role. What is known is that adjustment disorders are common, they can affect anyone of any age, race or gender, and the risk is greater for those with histories of childhood trauma and without strong social support networks.

Treating Adjustment Disorder

If you feel you may be experiencing an adjustment disorder, don’t delay in reaching out for help. Usually this involves a combination of medication and psychotherapy, which can help you understand the source of your stress and learn skills to deal with it. Yes, symptoms sometimes resolve themselves within six months, but it can be miserable waiting to see if that will be the case for you. Delay can also spark substance use problems, since turning to drugs or alcohol to cope with the distress of adjustment disorder is a common response. And you should never ignore any suicidal thoughts. There are also big pluses to seeking therapeutic care as soon as possible: you’ll not only minimize the fallout from your adjustment disorder and likely recover sooner, you’ll learn coping skills that will teach you healthier ways to respond to stress — and that will serve you well throughout your life.

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