Work problems, going away to school, an illness — any number of life changes can cause stress. Most of the time, people adjust to such changes within a few months. But if you continue to feel down or self-destructive, you may have an adjustment disorder.
An adjustment disorder is a type of stress-related mental illness. You may feel anxious or depressed, or even have thoughts of suicide. Your normal daily routines may feel overwhelming. Or you may make reckless decisions. In essence, you have a hard time adjusting to change in your life, and it has serious consequences.
You don't have to tough it out on your own, though. Adjustment disorder treatment — usually brief — is likely to help you regain your emotional footing.
Adjustment disorders symptoms vary from person to person. The symptoms you have may be different from those of someone else with an adjustment disorder. But for everyone, symptoms of an adjustment disorder begin within three months of a stressful event in your life.
Signs and symptoms of adjustment disorder may affect how you feel and think about yourself or life, including:
Signs and symptoms of adjustment disorder may affect your actions or behavior, such as:
How long you have symptoms of an adjustment disorder also can vary:
Sometimes the stressful change in your life goes away, and your symptoms of adjustment disorder get better because the stress has eased. But often, 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'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 or someone you know has thoughts of suicide, get help right away. Consider talking to your doctor, nurse, a mental health professional, a trusted family member or friend, or your faith leader.
If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately. Or call a suicide hot line number. In the United States, you can call the 24-hour National Suicide Prevention Lifeline at 800-273-8255 (toll-free) to talk with a trained counselor.
Researchers are still trying to figure out what causes adjustment disorders. As with other mental disorders, the cause is likely complex and may involve genetics, your life experiences, your temperament and even changes in the natural chemicals in the brain.
Adjustment disorders are diagnosed based on signs and symptoms and a thorough psychological evaluation. To be diagnosed with adjustment disorder, you must meet criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual, published by the American Psychiatric Association, is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment.
For an adjustment disorder to be diagnosed, several criteria must be met, including:
Your doctor may ask detailed questions about how you feel and how you spend your time. This will help pinpoint which type of adjustment disorder you have. There are six main types. Although they're all related, each type has certain signs and symptoms:
Most adults with adjustment disorder get better within six months and don't have long-term complications. However, people who also have another mental health disorder, a substance abuse problem or a chronic adjustment disorder are more likely to have long-term mental health problems, which may include:
Compared with adults, teenagers with adjustment disorder — especially chronic adjustment disorder marked by behavioral problems — are at significantly increased risk of long-term problems. In addition to depression, substance abuse and suicidal behavior, teenagers with adjustment disorder are at risk of developing psychiatric disorders such as:
There are no guaranteed ways to prevent adjustment disorder. But developing healthy coping skills and learning to be resilient may help you during times of high stress. Resilience is the ability to adapt well to stress, adversity, trauma or tragedy. Some of the ways you can improve your resilience are:
If you know that a stressful situation is coming up — such as a move or retirement — call on your inner strength in advance. Remind yourself that you can get through it. In addition, consider checking in with your doctor or mental health provider to review healthy ways to manage your stress.
When you face a stressful event or major life change, take steps to care for your emotional well-being. Talking about your feelings and asking for help is important to aid your recovery from adjustment disorder.
Do what works for you. For example:
If it's your child who's having difficulty adjusting, try gently encouraging him or her to talk about feelings. 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. Take these steps to help:
If you use these kinds of self-care steps but they don't seem to be helping, talk with your doctor for advice.
Although the cause of adjustment disorders is unknown, some things make you more likely to have an adjustment disorder. Among children and teenagers, both boys and girls have about the same chance of having adjustment disorders. Among adults, women are twice as likely to be diagnosed with adjustment disorders.
One or more stressful life events may put you at risk of developing an adjustment disorder. It may involve almost any type of stressful event in your life. Both positive and negative events can cause extreme stress. Some common examples include:
In some cases, people who face an ongoing stressful situation — such as living in a crime-ridden neighborhood — can reach a breaking point and develop an adjustment disorder.
If you generally don't cope well with change or you don't have a strong support system, you may be more likely to have an extreme reaction to a stressful event.
Your risk of an adjustment disorder may be higher if you experienced stress in early childhood. Overprotective or abusive parenting, family disruptions, and frequent moves early in life may make you feel like you're unable to control events in your life. When difficulties then arise, you may have trouble coping.
Other risk factors may include: