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 Adjustment Disorder 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 for Adjustment Disorder can vary and are highly dependent on individual perception and coping mechanisms. Common causes include:

  • Death of a loved one: Grieving a significant loss can disrupt daily life and emotional stability.
  • Divorce or relationship issues: Navigating the end of a relationship often brings emotional and logistical challenges.
  • Health diagnoses: Being diagnosed with a serious illness can be a major stressor.
  • Relocation: Moving away from familiar surroundings can create feelings of isolation and stress.
  • Job loss: Financial instability and identity issues often follow losing a job.
  • Traumatic events: Experiencing or witnessing violence, accidents, or assaults can trigger AD​

Recognizing the Symptoms

Symptoms of Adjustment Disorder often mirror those of Major Depressive Disorder (MDD) but are typically less severe and linked to a specific event.

These symptoms can vary widely but often include:

  • Loss of interest in hobbies or daily activities
  • Persistent feelings of sadness and frequent crying
  • Constant worry, nervousness, or stress
  • Difficulty sleeping
  • Changes in appetite, either poor or excessive eating
  • Increased use of alcohol or other substances
  • Trouble concentrating
  • Withdrawal from social interactions
  • Physical symptoms like headaches and heart palpitations
  • Suicidal thoughts or behaviors​

Diagnosis and Criteria

Diagnosing Adjustment Disorder involves meeting specific criteria outlined in the DSM-5. These criteria include:

  • 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

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

  1. Adjustment disorder with anxiety: Individuals may experience preoccupation with future events, feelings of overwhelm, restlessness, difficulty concentrating on tasks like school or work. Children with this type often exhibit separation anxiety, becoming highly distressed when away from loved ones.
  2. Adjustment disorder with depressed mood: Similar to depression, this type involves periods of deep sadness that interfere with daily activities and routines.
  3. Adjustment disorder with anxiety and depressed mood: This type combines symptoms of both anxiety and depression, resulting in simultaneous feelings of intense worry and sadness.
  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 adjustment disorder.

Additional Types:

  • 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: In this type, symptoms can include a blend of anxiety, depression, and impulsive or careless behavior, affecting both the individual and potentially their child.

Common Forms of Treatment

Effective treatment for Adjustment Disorder often involves a combination of psychotherapy and, in some cases, medication.

Psychotherapy: This is the primary treatment for AD. It helps individuals identify stressors and develop strategies to manage their response. Cognitive Behavioral Therapy (CBT) is particularly effective as it focuses on changing negative thought patterns and behaviors. Family therapy may also be beneficial, especially for children and adolescents​​.

Medication: While not always necessary, medications can help alleviate severe symptoms, such as anxiety or depression. Anti-anxiety medications and antidepressants are commonly prescribed to help manage these symptoms in the short term.

Coping Strategies

Beyond professional treatment, several strategies can help manage the symptoms of Adjustment Disorder.

Reduce Expected Stress: When facing predictable stressors like moving house, seek help with tasks to reduce your burden. This can help manage the stress associated with significant life changes.

Join a Support Group: Sharing your experiences with others facing similar challenges can provide comfort and reduce feelings of isolation. Support groups can be especially effective for those dealing with trauma, bullying, or significant life changes.

Lean on Your Support System: Having a trusted friend or family member to talk to can provide emotional relief. A strong support system is crucial during tough times.

Healthy Coping Methods: Avoid self-destructive behaviors like drug or alcohol use. Instead, focus on healthy activities such as exercise, reading, or spending quality time with loved ones​.

Prevention Tips

While it's impossible to prevent all causes of Adjustment Disorder, building resilience and a strong support system can help manage stress more effectively. Early intervention when stress first arises can also be crucial in preventing the escalation of symptoms.

Adjustment Disorder and Other Conditions

In this part, we will discuss distinguishing between AD and similar conditions. The conditions are Major Depression, PTSD, and Anxiety.

Adjustment Disorder vs. Major Depression

While both conditions share similar symptoms such as sadness and loss of interest, Adjustment Disorder is directly tied to a specific stressor and tends to be less severe. Major Depression is more persistent and not necessarily linked to a particular event​​.

Adjustment Disorder vs. PTSD

PTSD is a response to a traumatic event and involves symptoms like flashbacks, severe anxiety, and avoidance behaviors. Adjustment Disorder is typically related to less severe stressors and does not include the intense reliving of the event seen in PTSD​.

Adjustment Disorder vs. Anxiety

Both conditions involve excessive worry and stress. However, Adjustment Disorder is a short-term response to a specific stressor, whereas anxiety disorders can be more generalized and persistent without a clear triggering event​.

Seek Help Today at Psychology Blossom Clinic

Adjustment Disorder can significantly impact your life, but effective treatment and support are available.

At Psychology Blossom Clinic, our specialized services offer tailored treatment plans to help you manage symptoms and regain stability. Whether you're experiencing stress, anxiety, or depression related to life changes, our 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, Adjustment Disorder is considered a mental illness characterized by an excessive response to a significant life change or stressor​​.