Adjustment Disorder (Stress Response Syndrome)

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.

Someone who experiences AD may have a warped perception of reality and so when even a trivial problem arises, they might perceive it as a major threat. In such cases, we experience heightened stress levels and display much more intense reactions which cause impairment to social, cognitive, and day-to-day functioning. 

What Causes Adjustment Disorder?

The triggers can vary and are highly dependent on coping mechanisms and how people see the world around them.

  • 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 - It is not uncommon that 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.

 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 less severe and are triggered by a specific event.

They can be various, but this is the list of the most common ones:

  • No longer interested in hobbies and things you used to enjoy
  • Constantly feeling sad and crying a lot
  • Being worried all the time, and feeling sad and nervous
  • Difficulty sleeping
  • Changes in appetite, eating too much or too little
  • Excessive drinking and substance use
  • Trouble concentrating
  • Wanting to be alone all the time
  • Headaches and feelings of having a fast-beating, fluttering, or pounding heart
  • Thinking about and trying to commit suicide

Diagnosis and Criteria

To be diagnosed a person should meet the following criteria outlined in the DSM-5.

  • Symptoms must begin within three months of the stressor.
  • The symptoms are more severe than what would normally be expected in response to the event.
  • The symptoms cause significant impairment in social, occupational, or other important areas of functioning.
  • The symptoms do not represent normal grief and do not meet the criteria for another mental disorder​.

Types of Adjustment Disorders

As outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there are several common forms of this condition. Those are:

  1. Adjustment disorder with anxiety: Preoccupation with future events, feeling overwhelmed, restlessness, and difficulty concentrating on tasks like school or work are characteristics of this type. Children will often express separation anxiety, becoming highly distressed when away from loved ones.
  2. Adjustment disorder with depressed mood: This type is characterized by periods of deep sadness that disrupts everyday life.
  3. Adjustment disorder with anxiety and depressed mood: Feelings of depression and anxiety combined are characteristic in this case.
  4. Adjustment disorder unspecified: When an individual's reaction to stress does not fit into the above categories, they may receive a diagnosis of unspecified AD.

Additional Types:

A few more types do not fall into the previous classification but are worth mentioning. Those are:

  • Adjustment disorder with disturbance of conduct: This can manifest as behavioral problems such as rule-breaking, destruction of property, or reckless behavior.
  • Adjustment disorder with mixed disturbance of emotions and conduct: This type combines symptoms of all of the above. It is a blend of anxiety, depression, and impulsive or careless behaviour.

Treatment

The treatment includes a combination of psychotherapy and, sometimes, medication.

Psychotherapy is a primary treatment. During this treatment, people learn to identify and deal with stressors. Cognitive Behavioural Therapy (CBT) has proven very effective as its focus is on changing negative thought patterns and behaviours. Family therapy is beneficial for children and adolescents.

Medication (antidepressants and anti-anxiety medication) is not always necessary but can help in reducing severe symptoms, such as anxiety and depression. They are prescribed as a short-term solution.

Coping Strategies

You can also develop some coping strategies that will help you, aside from professional treatment.

Try to reduce exposure to stressors. For example, if you are moving, ask for help in doing some tasks to ease your burden. This may help you in managing stress when making such a big life change.

Support groups are a great place in which you can share your experiences with others who feel the way you do. They are the place where you will find comfort and reduce feelings of isolation. Support groups can especially help people dealing with trauma, bullying, or significant life changes.

Having a trusted friend or family member to talk to can provide emotional relief. This is very important during tough times.

Try to avoid drinking and using drugs to cope. Instead, turn your focus on healthy activities, such as exercising, reading, or spending time with family and friends.

Prevention 

Not all causes of AD can be prevented. A strong support system and working on yourself can help you manage better. Early intervention when stress first arises can also be crucial in preventing the escalation of symptoms.

Adjustment Disorder and Other Conditions

This part talks about the differences between AD and similar conditions. The conditions are Major Depression, PTSD, and Anxiety.

Adjustment Disorder vs. Major Depression

The main difference between these two conditions is in the type of the stressor and the severity of the symptoms. AD occurs because of a specific stressor and is not as severe, while major depression is not linked to one specific event and has more pronounced symptoms.

Adjustment Disorder vs. PTSD

The main difference is in the response to the traumatic event. PTSD includes flashbacks, severe anxiety, and avoidance behaviours. AD is related to less intense reliving of the event and the event itself is less severe.

Adjustment Disorder vs. Anxiety

They differ in the length of response and triggering event. While both conditions involve excess worry and stress, AD is short-term and related to a specific event, while anxiety disorders are more persistent and are not related to a singular event.

We are here for you

This condition can have a significant impact on your life, but effective treatment and support can make you feel good again.

At Psychology Blossom Clinic, we specialize in treatments that are tailored to you and help you manage symptoms. Our committed team is here to support you.

Contact us today to schedule a consultation and start your journey towards better mental health.

150 Cecil Street #07-02
Wing on Life Building
Singapore 069543

Message: +65 8800 0554

Phone: +65 8686 8592

[email protected]

Yes, it is considered a mental illness characterized by an excessive response to a significant life change or stressor​​.