Adjustment disorders are stress-related conditions. You experience more stress than would normally be expected in response to a stressful or unexpected event, and the stress causes significant problems in your relationships, at work or at school.
Work problems, going away to school, an illness, death of a close family member or any number of life changes can cause stress. Most of the time, people adjust to such changes within a few months. But if you have an adjustment disorder, you continue to have emotional or behavioral reactions that can contribute to feeling anxious or depressed.
You don't have to tough it out on your own, though. Treatment can be brief and it's likely to help you regain your emotional footing.
Signs and symptoms depend on the type of adjustment disorder and can vary from person to person. You experience more stress than would normally be expected in response to a stressful event, and the stress causes significant problems in your life.
Adjustment disorders affect how you feel and think about yourself and the world and may also affect your actions or behavior. Some examples include:
Symptoms of an adjustment disorder start within three months of a stressful event and last no longer than 6 months after the end of the stressful event. However, persistent or chronic adjustment disorders can continue for more than 6 months, especially if the stressor is ongoing, such as unemployment.
Usually stressors are temporary, and we learn to cope with them over time. Symptoms of adjustment disorder get better because the stress has eased. But sometimes the stressful event remains a part of your life. Or a new stressful situation comes up, and you face the same emotional struggles all over again.
Talk to your doctor if you continue to struggle or if you're having trouble getting through each day. You can get treatment to help you cope better with stressful events and feel better about life again.
If you have concerns about your child's adjustment or behavior, talk with your child's pediatrician.
If you have thoughts of hurting yourself or someone else, call 911 or your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend. Or call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to reach a trained counselor.
Adjustment disorders are caused by significant changes or stressors in your life. Genetics, your life experiences, and your temperament may increase your likelihood of developing an adjustment disorder.
Some things may make you more likely to have an adjustment disorder.
Stressful life events — both positive and negative — may put you at risk of developing an adjustment disorder. For example:
Life experiences can impact how you cope with stress. For example, your risk of developing an adjustment disorder may be increased if you:
If adjustment disorders do not resolve, they can eventually lead to more serious mental health problems such as anxiety disorders, depression or substance abuse.
There are no guaranteed ways to prevent adjustment disorders. But developing healthy coping skills and learning to be resilient may help you during times of high stress.
If you know that a stressful situation is coming up — such as a move or retirement — call on your inner strength, increase your healthy habits and rally your social supports in advance. Remind yourself that this is usually time-limited and that you can get through it. Also consider checking in with your doctor or mental health professional to review healthy ways to manage your stress.
Diagnosis of adjustment disorders is based on identification of major life stressors, your symptoms and how they impact your ability to function. Your doctor will ask about your medical, mental health and social history. He or she may use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
For diagnosis of adjustment disorders, the DSM-5 lists these criteria:
The DSM-5 lists six different types of adjustment disorders. Although they're all related, each type has unique signs and symptoms. Adjustment disorders can be:
How long you have signs and symptoms of an adjustment disorder also can vary. Adjustment disorders can be:
Many people with adjustment disorders find treatment helpful, and they often need only brief treatment. Others, including those with persistent adjustment disorders or ongoing stressors, may benefit from longer treatment. Treatments for adjustment disorders include psychotherapy, medications or both.
Psychotherapy, also called talk therapy, is the main treatment for adjustment disorders. This can be provided as individual, group or family therapy. Therapy can:
Medications such as antidepressants and anti-anxiety drugs may be added to help with symptoms of depression and anxiety.
As with therapy, you may need medications only for a few months, but don't stop taking any medication without talking with your doctor first. If stopped suddenly, some medications, such as certain antidepressants, may cause withdrawal-like symptoms.
Here are some steps you can take to care for your emotional well-being.
Resilience is the ability to adapt well to stress, adversity, trauma or tragedy — basically, the ability to bounce back after experiencing a difficult event. Building resilience may vary from person to person, but consider these strategies:
It may help you to talk things over with caring family and friends, receive support from a faith community, or find a support group geared toward your situation.
If your child is having difficulty adjusting, try gently encouraging your child to talk about what he or she is going through. Many parents assume that talking about a difficult change, such as divorce, will make a child feel worse. But your child needs the opportunity to express feelings of grief and to hear your reassurance that you'll remain a constant source of love and support.
Whether you start by seeing your primary care doctor or a mental health professional for evaluation and treatment, here's some guidance to help you prepare for your appointment, and what to expect from your doctor.
If possible, you may want to take notes during the visit or bring along a family member or friend to help you remember information.
To prepare for your appointment, make a list of:
Some questions to ask your doctor may include:
Don't hesitate to ask other questions during your appointment.
Your doctor will likely ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to focus on. Your doctor may ask:
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