Defining an Adjustment Disorder

Sometimes called “situational depression”, an Adjustment Disorder presents as an extreme and long-lasting reaction to a difficult event. Oftentimes, this type of disorder is hard to diagnose because the patient is not aware that their reaction is outsized. Symptoms also often look similar to those of other mental health disorders.

An Anger Disorder can come in six different forms:

  • Anger Disorder with anxiety
  • Anger Disorder with depression
  • Anger Disorder with conduct disruption
  • Anger Disorder with mixed anxiety and depressed mood
  • Anger Disorder with mixed disturbance of conduct and emotions
  • Anger Disorder Unspecified

Diagnosis of any type of Adjustment Disorder requires the help of a mental health professional. 

Adjustment Disorder – When Grief is Not Healthy

Triggers such as traumatic events or significant personal losses can result in negative mindsets in even healthy patients. Distinguishing between healthy grief and an Adjustment Disorder requires diagnosis as defined by the DSM-5. The DSM-5 defines the diagnostic criteria for mental health disorders and is the result of decades of work by the mental health profession. 

Differentiating between normal, negative feelings as a result of trauma and something like an Adjustment Disorder requires comparison of a patient’s symptoms to DSM-5 criteria. A patient may exhibit some but not all of the criteria for diagnosis. In many cases, negative emotions are normal and healthy reactions.  

Even in cases where a stress or grief reaction is extreme, the patient still may not meet diagnostic criteria for an Adjustment Disorder. Such individuals might be experiencing other disorders, such as PTSD or panic attacks. It is the job of a mental health professional to make any diagnosis. 

The Symptoms of an Adjustment Disorder 

The most common characteristics of adjustment disorder are that a patient’s distress at an event outpaces the event itself which, in turn, affects their ability to conduct their normal, daily lives. Someone experiencing this state can exhibit the following symptoms:

  • Suicidal ideation
  • Hopeless feelings
  • No interest in preferred activities
  • Anxiety and perseveration
  • Withdrawing from friends and loved ones
  • Faulty concentration
  • An inability to execute necessary tasks
  • Crying jags
  • Insomnia or disordered sleeping

Since these symptoms can present with other mental health disorders, proper diagnosis by a professional is essential.  DSM-5 diagnostic criteria for an Adjustment Disorder include:

  • Symptoms presenting within three months of the trauma
  • Patients exhibiting more and more intense feelings than would typically result from a trauma
  • Negative thoughts and feelings interfering with daily life
  • No pre-existing condition to explain negative thoughts and behaviors

The Causes of an Adjustment Disorder

Anything from losing a job to being the victim of a crime can lead to an adjustment disorder. Sometimes, even, the trigger is something that would typically be considered a positive event, such as leaving for college.  In yet other scenarios, it can be a combination of events that trigger an Adjustment Disorder, such as experiencing illness and divorce at the same time. 

Finally, some triggers can occur on an ongoing basis. Anyone who experiences domestic abuse, for example, could be continuously triggered. 

Does Chronic Adjustment Disorder Exist?

Adjustment Disorders come in chronic and acute forms. In an acute version, the symptoms last for fewer than six months, while in a chronic version the symptoms last for longer than six months.  

In acute Adjustment Disorder, the removal of triggers or the implementation of coping mechanism can stop symptoms. With chronic cases, patients may still experience symptoms after the removal of triggers. 

Both versions require intervention, but a patient with chronic Adjustment Disorder may need therapeutic intervention in the longer term. 

Treating Adjustment Disorder  

As with most mental health disorders, treating this disorder can take the form of therapy, medications, lifestyle changes, or some combination thereof. Therapy can take the form of individual, family, or group sessions, and can include:

  • Learning management skills
  • Learning to ask for support
  • Identifying negative patterns
  • Understanding triggers
  • Implementing coping mechanisms
  • Talk therapy
  • Modifying negative behaviors

Medication can also serve as an effective intervention for Adjustment Disorder. Options such as antidepressants or anti-anxiety medications can help in certain cases, depending on symptoms and severity.

Alternatively or as a supplement to other interventions, patients can implement lifestyle changes in the treatment of Adjustment Disorder such as:

  • Bonding or reconnecting with a support system
  • Focusing on the positive each day
  • Addressing problems instead of avoiding them
  • Maintaining a list of personal success
  • Eating healthy foods and getting enough exercise