Adjustment Disorders

Adjustment disorder is a group of symptoms, such as stress, feeling sad or hopeless, as well as physical symptoms that can occur after you go through a stressful life event. The symptoms occur because you are having a hard time coping. Your reaction may be stronger than expected for the type of event that occurred.

Causes and risk factors for adjustment disorder

Adjustment disorder impacts people differently and can occur at any age. The causes of adjustment disorder are a complex interplay of genetic, environmental, and physical risk factors working together.

Common types of stressors that can trigger adjustment disorder include:

  • Ending a relationship or marriage
  • Losing or changing jobs
  • Death of a loved one
  • Developing a serious, chronic illness
  • Being the victim of a crime
  • Major life changes – getting married, having a baby
  • Living through a natural disaster
  • Retirement

Triggers of stress in teenagers and young adults may include:

  • Family problems or conflict
  • School problems
  • Sexuality issues

Risk Factors:

  • Other mental health disorders
  • Lack of support system
  • Difficult life circumstances
  • Chronic stressors
  • Traumatic events during childhood
  • Physical or sexual abuse or assault
  • Overprotective or abusive parenting as a child
  • Family disruptions as a child
  • Frequent moves in early life

There is no way to predict which people, who are affected by the same stressor, are likely to develop an adjustment disorder. Your social skills before the event and how you have learned to deal with stress in the past may play roles.

Signs and symptoms of adjustment disorder

The symptoms of adjustment disorder do change from person to person, often widely enough that a diagnosis of adjustment disorder is challenging. The one constant characteristic of adjustment disorder is the symptoms appearing within a certain time period after a major, stressful life event.

Behavioural Symptoms:

  • Frequent crying
  • Fighting with other people
  • Being unusually argumentative
  • Ignoring bills and other financial obligations
  • Avoiding friends, family, and loved ones
  • Poor work or school performance
  • Being late to work or school frequently
  • Excessive absenteeism

Physical Symptoms:

  • Trouble eating
  • Changes in sleeping patterns

Cognitive Symptoms:

  • Difficulties making decisions
  • Trouble concentrating

Psychosocial Symptoms:

  • Sadness
  • Loss of self-esteem
  • Feeling isolated, apart from others
  • Hopelessness
  • Inability to feel joy or pleasure
  • Anxiety and nervousness
  • Feeling “on-edge”
  • Feelings of being overwhelmed
  • Self-harm
  • Thoughts of suicide

To have adjustment disorder, you must have the following:

  • The symptoms clearly come after a stressor, most often within 3 months
  • The symptoms are more severe than would be expected
  • There do not appear to be other disorders involved
  • The symptoms are not part of normal grieving for the death of a loved one


The main goal of treatment is to relieve symptoms and help you return to a similar level of functioning as before the stressful event occurred. The most recommended treatments are CBT and Narrative Therapy which can help you identify or change your responses to the stressors in your life.

In general therapy can:

  • Provide emotional support
  • Help you get back to your normal routine
  • Help you learn why the stressful event affected you so much
  • Help you learn stress-management and coping skills to deal with stressful events

Outlook (Prognosis)

With the right help and support, you should get better quickly. Adjustment Disorders usually do not last longer than 6 months, unless the stressor continues to be present. I will be happy to discuss any concerns you have that you may have an adjustment disorder. CBT and Person Centred Counselling are often most effective for treatment of Adjustment Disorders

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