Signs, Symptoms, & Effects of Adjustment Disorder

Learn about adjustment disorder

Family issues, problems at work or school, arguments with friends, moving to a new city – these are just a few of the life stressors we experience on a regular basis. Most of the time we find a way to adjust within a few months by employing coping strategies we’ve used successfully before. However, sometimes the picture becomes more complex. There may be multiple stressors that build on each other, a particularly difficult stressor may keep reoccurring, or a stressor that occurs continuously, such as a chronic illness. Stressors can affect you, your entire family, your community, or a large group (e.g. a terrorist attack). Sometimes stressful events can be related to specific life stages, such as going to college, getting married, or becoming a parent.

Given how complex and busy our lives have become in this technological age, it is not surprising that adjustment disorders are a relatively commonly experience. It is rare that we encounter only one single stressor at a time because of the number of different roles we take on. Switching from one role to another (e.g. parent in the morning, business person after the children are in school, spouse in the evening) in and of itself can be stressful enough over time to lead to an adjustment disorder.

Adjustment reactions are diagnoses based on six categories:

• With Depressed Mood
• With Anxiety
• With Anxiety and Depressed Mood
• With Disturbance of Conduct
• With Mixed Disturbance of Emotions and Conduct
• Unspecified Type – may include a mixture of symptoms from the above categories

At Options, we know just how much pressure the realities of day to day life can place on you. We also understand that the term “adjustment disorder” does not encompass all the difficulties and pain you are experiencing, and that it is rare that an adjustment disorder develops without additional mental health or substance use disorders. Not only are our staff compassionate and supportive, but they are specially trained to help you with whatever problems or disorders you may be struggling with.

Adjustment disorder statistics

Adjustment disorders are among the most frequently experienced mental health disorders. However given the range of stressors involved, severity levels, and settings in which data is collected, the reported prevalence estimates vary significantly. When obtaining rates from outpatient clinics, prevalence rates have been estimated to range from 5% to 20%. The rates are significantly higher for those being treated in hospital evaluation settings, with estimates reaching 50%, and sometimes higher. Women are twice as likely to have the disorder compared with men, though in children no gender differences have been reported.

Causes and risk factors for adjustment disorder

The exact cause of adjustment disorders have not been determined to date, but likely are a result of the interaction of genetics, exposure to stressors, and altered levels of certain chemicals in the brain. There is evidence however, that certain things increase the likelihood of developing the disorder. These include:

Stressful Events – As previously mentioned, one or more stressful life events, a continuous or recurrent stressor, or a stressor associated with a life stage increases the risk that an adjustment disorder will develop.

Life Experience – If you have a history of stressors, but never developed adaptive coping strategies to handle them or lack an adequate social support network to rely upon when feeling overwhelmed, you may be at an increased risk for developing an adjustment disorder.

Other Mental Health Problems – The existence of other mental or medical health problems increases the likelihood that an adjustment disorder will develop.

Signs and symptoms of adjustment disorder

An adjustment disorder can have a wide variety of symptoms, which may include:

• Feelings of hopelessness and helplessness
• Lack of optimism
• Loss of ability to feel pleasure in previously pleasurable events or activities
• Sadness
• Tearfulness and crying
• A general state of anxiety
• Worry or concern related to the stressor(s)
• Headaches
• Stomach pain or nausea
• Heart palpitations or tachycardia
• Social withdrawal or isolation from important others and social engagements
• Avoiding work or school
• Behavior involving harm or destruction of property, such as violence, drinking alcohol and driving, or vandalism
• Increased or decreased appetite
• Insomnia
• Fatigue
• Substance abuse or addiction

For children and adolescents the disorder is generally displayed through behavioral symptoms.  For example, youth may steal, fight, skip school, run away, or generally act out in multiple settings. These symptoms are different from those in adults, who are more likely to express symptoms related to negative emotions such as sadness, anxiety, or depression.

Effects of adjustment disorder

The majority of adults with adjustment disorders improve within six months, but those that don’t can face some serious effects. These include:

• Depression
• Alcohol abuse
• Drug addiction
• Suicidal thoughts and behavior
• Depressed immune system leading to physical illness

Adolescents who suffer from a chronic adjustment disorder, especially when accompanied by behavior problems, are at risk for long term psychological problems. In particular, they are at significant risk for:

• Schizophrenia
• Bipolar disorder
• Substance abuse disorders
• Social avoidance
• Schizoid personality disorder
• Antisocial personality disorder
• Incarceration due to delinquent activities
• Accidents due to decreased inhibitions and engaging in hazardous activities while using a substance

Adjustment disorder and co-occurring disorders

Adjustment disorder may occur alongside other mental health concerns. The American Psychiatric Association listed some of the potential co-occurring disorders, including:

• Specific phobias
• Obsessive-compulsive disorder
• Panic disorder
• Generalized anxiety disorder
• Bipolar disorder
• Depressive disorders
• Social anxiety disorder