A person with an adjustment disorder experiences a stronger behavioural or emotional response to a stressful event or significant life change than is normal. They may continue to feel anxious, depressed, or experience changes in their behaviour for longer than would be expected. This heightened stress response has a negative impact on their thoughts, feelings, and behaviours, which can lead to problems at work, school, in their relationships, and in their day to day functioning.
Adjustment disorders develop within 3 months of a stressful event or life change and can be caused by a mix of genetic and environmental factors. People with certain personality characteristics, a history of stress or trauma during childhood, a family history of mental health conditions, and/or those who experience multiple stressful events at once can be at an increased risk of developing an adjustment disorder. The onset of an adjustment disorder can be triggered by a range of events such as the death of a loved one, a natural disaster, divorce, having a baby, or starting a new job.
Adjustment disorders usually last less than 6 months. Symptoms tend to go away once the stressor is over or the individual develops effective strategies to manage stress. However, adjustment disorders can be persistent or chronic, meaning symptoms remain for longer than 6 months. The symptoms experienced can also vary. Adults tend to experience more depressive symptoms, whereas children and adolescents show more behavioural issues (e.g. ‘act out’).
There are six types of adjustment disorder -
- Adjustment disorder with depressed mood
- Adjustment disorder with anxiety
- Adjustment disorder with mixed anxiety and depressed mood
- Adjustment disorder with disturbance of conduct
- Adjustment disorder with mixed disturbance of emotions and conduct
- Adjustment disorder unspecified
- Emotional and/or behavioural problems following a stressful event or significant life change.
- Experiencing more stress than expected after a stressful event or life change which leads to problems at work, school, in relationships, etc.
- Feeling anxious, worried, overwhelmed
- Feeling hopeless or sad
- Loss of interest in things you used to enjoy
- Crying often
- Difficulty sleeping
- Decrease in appetite
- Difficulty concentrating
- Withdrawing from others - spending less time with family/ friends.
- Avoiding events and commitments - e.g. avoiding work, social events.
- Thoughts of harming yourself
- Thoughts of suicide or death
There are effective treatments available for adjustment disorders. These focus on helping the individual learn healthy coping skills and stress management techniques to help them get back to normal functioning. Treatment given will differ based on age, symptoms, subtype of adjustment disorder and other individual factors. It is important to seek treatment as adjustment disorders can have a significant impact on day to day life and increase the risk of developing other mental health conditions, such as anxiety disorders and depression.
Psychological Therapy:
The main treatment for adjustment disorders is talk therapy. Cognitive behavioural therapy (CBT) is a structured form of talk therapy which aims to change unhealthy thoughts, feelings, and behaviours. The goals of talk therapy for adjustment disorder include learning why particular events/ stressors led to the heightened stress response, improving problem-solving and coping skills, developing stress management techniques, and addressing other emotional and behavioural issues.
Family Therapy:
For children and adolescents with adjustment disorders, family therapy can be beneficial. Family therapy focuses on improving family interactions, strengthening family relationships to support the child/ teen, and addressing any other issues within the family.
Medication:
In some cases anti-anxiety or antidepressant medications may be prescribed to treat anxiety and depressive symptoms.
Other Ways to Manage Adjustment Disorders:
Developing healthy stress management techniques and building resilience can help you to respond better to stressful events and significant life changes. Some ways to improve resilience include developing a good support system, doing things that make you happy and give you a sense of purpose, finding ways to manage negative emotions, and maintaining a healthy lifestyle.
This video created by Impireum gives an overview of adjustment disorders. It explains what adjustment disorders are, the symptoms, and why they develop.
The article from the American Psychological Association (APA) outlines some techniques to help you manage stress. These tips can help you develop more adaptive ways of coping with stressful situations and events, and ways to reduce general everyday stress.
This video provides some tips on how to cope with stress. Developing healthy ways to manage stress can help us cope when we are faced with stressful life events, and reduce the harm these events have on our physical and mental wellbeing.
For those who experience adjustment disorder with symptoms of anxiety, the Anxiety NZ Trust website can provide helpful information on living with anxiety and accessing support.
Anxiety NZ Trust is a non-profit, registered charity who support kiwis suffering from anxiety and anxiety related disorders. Their aim is to raise awareness and provide support for those living with these conditions. They run workshops and support groups, and provide education and treatment.
Depression NZ is a good resource for those with adjustment disorder who experience symptoms of depression. The Depression NZ website has information to help you recognise the symptoms of depression, develop a better understanding of the condition, and learn how to access help and support.