Adjustment Disorder (AD): Causes, Symptoms, and Proven Ways to Recover
Adjustment Disorder as the name suggests occurs due to an identifiable life-changing event such as loss of job, changing school, or divorce. Stressors may or may not be extreme events. In some cases, they may be traumatic, such as the sudden loss of a parent. In other cases, events could be relatively minor and seemingly trivial. What matters most is the individual’s appraisal and the context—how prepared they felt, what resources were available, and whether the change piled onto other ongoing stressors.
Someone who experiences AD may have a warped or narrowed perception of reality in the short term and, when even a trivial problem arises, might perceive it as a major threat. As stress-response systems ramp up, people can feel flooded, vigilant, or hopeless. This cascade can drive heightened stress levels and much more intense reactions than usual, causing impairment to social, cognitive, and day-to-day functioning. Importantly, AD is not a character flaw; it is a time-limited stress response that improves with the right supports.
What Causes Adjustment Disorder?
The triggers can vary and are highly dependent on coping mechanisms and how people see the world around them. What overwhelms one person may feel manageable to another, depending on timing, previous losses, personality, and access to support. Common stressors include:
- Death of a loved one — Grief can significantly affect daily life and emotional stability.
- Relationship issues and divorce — Getting over the end of a relationship can affect how we navigate our lives.
- Health diagnoses — Being diagnosed with a serious illness can be very stressful.
- Relocation — Moving can cause feelings of isolation and stress.
- Job loss — Losing a job can bring financial instability and identity issues.
- Traumatic events — Experiencing or witnessing acts of violence, assault, or accidents.
Risk and resilience factors also shape vulnerability. Previous episodes of anxiety or depression, limited social support, perfectionistic standards, or multiple stressors landing at once all increase risk. Protective factors include flexible thinking, problem-solving skills, stable routines, and emotionally supportive relationships.
Symptoms
It is important to note that the symptoms are often similar to those of Major Depressive Disorder (MDD). The difference is that they are generally less severe, tightly linked to a specific event, and time-limited when support is provided. Symptoms can vary, but common ones include:
- No longer interested in hobbies and things you used to enjoy.
- Persistent sadness and frequent crying spells.
- Worrying most of the time; feeling tense, nervous, or “on edge.”
- Difficulty sleeping or restless, non-restorative sleep.
- Changes in appetite—eating too much or too little.
- Increased alcohol use or substance use to cope.
- Trouble concentrating; mind going blank under stress.
- Social withdrawal; wanting to be alone most of the time.
- Physical symptoms such as headaches, chest tightness, heart palpitations.
- In severe cases, thoughts about death or suicide and, rarely, attempts.
Children and teens may show irritability, behavioural outbursts, school refusal, somatic complaints before school, or regressions (e.g., clinginess). Adults may describe decision fatigue, rumination about the stressor, and a sense that small tasks feel enormous.
Diagnosis and Criteria
To be diagnosed, a person should meet the following criteria outlined in the DSM-5:
- Symptoms begin within three months of the identifiable stressor.
- The emotional or behavioural response is out of proportion to the severity or intensity of the stressor, taking culture and context into account.
- The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The symptoms do not represent normal grief alone and do not meet criteria for another mental disorder.
Clinicians may also specify whether the episode is acute (lasting less than 6 months) or persistent (chronic) when the stressor or its consequences continue. A careful assessment rules out medical causes (e.g., thyroid issues), substance effects, and primary mood or anxiety disorders.
Types of Adjustment Disorders
As outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), several forms exist:
- Adjustment disorder with anxiety: Worry about future events, feeling overwhelmed, restlessness, and difficulty concentrating at school or work. Children may show separation anxiety when away from loved ones.
- Adjustment disorder with depressed mood: Low mood, tearfulness, and hopeless thoughts that disrupt daily life.
- Adjustment disorder with mixed anxiety and depressed mood: A blend of anxious arousal and depressive symptoms.
- Adjustment disorder, unspecified: The reaction does not fit neatly into the above subtypes but still causes distress or impairment.
Additional behaviour-focused subtypes:
- With disturbance of conduct: Behavioural problems such as rule-breaking, aggression, vandalism, or reckless acts.
- With mixed disturbance of emotions and conduct: Combined symptoms of anxiety/depression with impulsive or oppositional behaviours.
How Adjustment Disorder Differs From Other Conditions
Adjustment Disorder vs. Major Depression: AD is time-locked to a stressor and tends to be milder; MDD may arise without a single trigger and typically includes more pervasive neurovegetative symptoms (e.g., pervasive anhedonia, psychomotor changes).
Adjustment Disorder vs. PTSD: PTSD requires exposure to a traumatic event plus hallmark symptoms (intrusions, avoidance, negative mood/cognition changes, arousal) lasting more than a month. AD reactions are stress-related but do not meet the full PTSD cluster and often relate to non-traumatic stressors.
Adjustment Disorder vs. Generalised Anxiety Disorder (GAD): GAD involves chronic, broad worry across domains for at least 6 months. AD is shorter in duration and tied to a specific precipitant.
Course, Prognosis, and Red Flags
With support, many people improve within weeks to a few months as the stressor passes or they adapt. Red flags that warrant urgent attention include persistent suicidal thinking, severe substance misuse, escalating aggression, or inability to perform essential self-care or caregiving tasks. Early, targeted intervention can prevent progression to Major Depressive Disorder, panic attacks, or chronic anxiety.
Treatment
The foundation of care is psychotherapy, often short-term and skills-focused. Medication can be considered for severe or disabling symptoms, typically as an adjunct.
Psychotherapy is a primary treatment. During therapy, people learn to identify and respond to stressors, rebuild routines, and restore problem-solving confidence. Cognitive Behavioural Therapy (CBT) is highly effective: it targets negative thought patterns (e.g., catastrophising, all-or-nothing thinking), increases behavioural activation, and teaches practical coping tools (sleep, activity pacing, assertive communication). For children and adolescents, Family therapy aligns routines and expectations, improves communication, and mobilises support at home.
Other evidence-based approaches include Acceptance and Commitment Therapy (ACT) for values-guided action amid uncomfortable feelings, Problem-Solving Therapy to structure decisions and reduce overwhelm, and Interpersonal Therapy (IPT) when role transitions (e.g., divorce, new city) or disputes are central. Brief supportive counselling and psychoeducation can also be sufficient when stressors are clear and time-limited.
Medication (antidepressants and anti-anxiety medication) is not always necessary but can help reduce severe symptoms such as intense anxiety, agitation, or insomnia. SSRIs or SNRIs may be used when depressive/anxious symptoms are prominent; short courses of sleep aids may be considered for acute insomnia. Medications are typically short-term and paired with therapy to build skills for lasting resilience.
Coping Strategies
Alongside professional treatment, self-care and environmental adjustments accelerate recovery:
- Reduce exposure to unnecessary stressors: If moving home, ask friends to help pack, label boxes by room, and schedule tasks over several days. Break big changes into smaller steps and protect rest windows.
- Structure the day: Consistent wake/sleep times, planned meals, and a brief morning plan reduce decision fatigue. “Start with three”: choose one work task, one life task, and one body/mood task (e.g., 10-minute walk).
- Activate support: Tell one trusted person what you are facing and how they can help (a check-in text, childcare for an hour, accompaniment to an appointment). Support groups reduce isolation—especially around grief, relocation, health diagnoses, or divorce.
- Practice grounding skills: Box breathing (inhale 4, hold 4, exhale 4, hold 4), the 5-4-3-2-1 senses exercise, or a two-minute body scan before difficult conversations or tasks.
- Move your body: Ten minutes of brisk walking improves mood and sleep. Stack movement onto routines (walk after lunch; stretch during kettle boil).
- Limit alcohol and drugs: They can worsen mood and sleep; swap with hot showers, reading, brief guided meditations, or time outdoors.
- Reclaim small joys: Schedule short activities that used to matter—music, football highlights, journaling, gardening. Mood follows action.
- Use thought checks: When you notice “I’ll never cope,” ask, “What is the next small step?” and “What would I tell a friend in my place?” Write down a balanced statement you can revisit.
Prevention
Not all causes of AD can be prevented. However, a strong support system and basic resilience practices reduce risk and shorten recovery time:
- Build “buffers” before predictable stressors (e.g., budget cushion, extra childcare during exams, meal prep before moving week).
- Maintain basic health habits (sleep, movement, nutrition, sunlight) to keep stress-response systems flexible.
- Seek early intervention when stress first arises to prevent escalation—one or two sessions of coaching can make a large difference.
Adjustment Disorder and Other Conditions
This section highlights key differences and overlap with related conditions: Major Depression, PTSD, and Anxiety.
Adjustment Disorder vs. Major Depression: AD is precipitated by a specific stressor; symptoms usually resolve as the person adapts or the stressor passes. Major Depression is more pervasive, may recur independent of events, and often requires longer-term treatment.
Adjustment Disorder vs. PTSD: PTSD involves re-experiencing (flashbacks, nightmares), persistent avoidance of trauma cues, negative shifts in beliefs and mood, and hyperarousal after a traumatic event. AD lacks the full PTSD symptom clusters and is commonly related to non-traumatic life changes.
Adjustment Disorder vs. Anxiety disorders: In Adjustment Issues, worry and physical tension are tightly linked to a recent stressor and shorter duration; in GAD, worry is broad, persistent, and lasts 6+ months across domains.
School and Workplace Support
Practical accommodations reduce impairment during recovery. At work: temporary flexible hours, reduced workload, clear priorities, and a single point of contact for communications. At school: check-ins with a counsellor, deadline extensions, alternative assessment formats, and calm-down passes. Communicate needs succinctly: “I’m experiencing an adjustment reaction to a recent event; for the next four weeks, these supports will help me continue performing while I stabilise.”
How Families and Friends Can Help
- Listen without quick fixes; reflect feelings (“This has been a huge change—no wonder you feel overwhelmed”).
- Offer concrete help (“I can drive Wednesday” rather than “Let me know if you need anything”).
- Encourage routines (meals, light activity, bedtime) and celebrate small wins.
- Watch for red flags—worsening hopelessness, substance misuse, or self-harm talk—and guide to professional help.
We are here for you
This condition can have a significant impact on your life, but effective treatment and support can help you feel like yourself again. At Psychology Blossom Clinic, we specialise in tailored treatments that help you manage symptoms, strengthen coping, and restore confidence. Our committed team is here to support you—step by step.
Contact us today to schedule a consultation and start your journey towards better mental health.
FAQ: Quick Answers
Is Adjustment Disorder a mental illness? Yes. It is a recognised mental health condition marked by an excessive response to a significant life change or stressor.
Is there a specific “test” for AD? No single test. Diagnosis is based on a clinical assessment of symptoms, timing, and the precipitating stressor.
At what age does it start? It can occur at any age. It is often identified in children and adolescents whose coping skills are still developing, but adults commonly experience it after major life changes.
Is Adjustment Disorder worse than depression? Symptoms can feel intense, but AD is typically less severe and more event-linked than Major Depression. Impact can still be significant and deserves support.
Is AD genetic? There is no single gene. Individual stress sensitivity and coping styles may have heritable components, and family environments shape responses to change.
What happens if AD goes untreated? Some cases resolve on their own as circumstances settle; others may persist or evolve into depression, anxiety disorders, or substance misuse. Early intervention reduces this risk.
We recommend This Video to those who wants to learn more about Adjustment Disorder.
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