Getting To Know Adjustment Disorder
October 21, 2020
Transitions are never easy. Whether starting a new job, going through a breakup, or moving house, it takes time to get used to change. Of course, some of us have more trouble adjusting than others. But sometimes, stress caused by life shifts can become completely debilitating. So much so that it becomes an illness. Here’s everything you need to know about Adjustment Disorder.
Adjustment Disorder is described as a prolonged and excessive adverse response to life stressors. It’s sometimes called ‘situational depression.’
Going through a rough time in response to stressful situations is expected--but those with adjustment disorders are significantly impaired by them. One of the hallmarks of the condition is a disproportionate reaction to an event. This could take different forms depending on the circumstance. Some include social impairment and trouble with school or work.
While it’s often thought to be triggered by a particular transition or event, adjustment disorder can result from recurrent stressors.
Here are a couple of examples.
A person who lives in a home with lots of fighting may start to show signs of adjustment disorder. The same goes for a person who happens to live in a high-crime spot. When stressors are compounded or happen repeatedly, it’s possible to suffer from the disorder at multiple points of one’s life.
Other examples include:
- Starting college/university
- The birth of a new brother or sister (for children)
- Natural Disasters
- Death of a loved one
- Newly diagnosed health problems either in oneself or a loved one
- Sexuality concerns
The name of the illness implies something temporary. Symptoms of adjustment disorder will typically start within three months of the triggering event and last until around six months after. If there is still little to no relief within the time-frame, another diagnosis will likely be considered.
Who Gets Adjustment Disorder?
While it’s not as well-known as depression, anxiety, or bipolar disorder, adjustment disorder is quite common. So much so that it accounts for 5-20% of those seeking outpatient treatment for mental disorders.
Like many mental illnesses, adjustment disorder doesn’t discriminate. A person from any cultural background, socioeconomic status, or age group can develop the condition.
With that said, it has been found that children seem to be more prone to it than adults. Additionally, adjustment disorder tends to look different as age progresses.
How Does Adjustment Disorder Show Up For Children?
Children and adolescents may be at greater risk of developing adjustment disorder because of where they are in their development. Since children don’t yet have a full handle on their emotions, they’re likely to not handle stress as well as healthy adults.
Similarly to adults, triggers for the disorder may vary between children, given the personal nature of stress. Commonalities may also be linked with cultural concerns.
In terms of its presentation, children and adolescents have a tendency towards acting out. If you begin to notice your well-mannered kid begin to call home from the principal’s office after a life-changing event, it might be adjustment disorder.
That’s just one common presentation.
Children might show signs by not showing interest in seeing friends, not completing homework assignments, or even fighting.
What About Grown Ups?
Adults may be more well-equipped to cope with stressful events, but it doesn’t mean they’re exempt from the condition.
Like children, it’s difficult to predict what may send someone into an adjustment disorder spiral. However, the situations setting off the illness will generally be specific to adults. Transitions like starting a new, high-achieving job or moving out on one’s own, and significant breakups may trigger symptoms. While a child may indirectly be affected by these events, through a parent/guardian, they will likely not experience them first-hand through a parent/guardian.
And given their more advanced brain development stage, adjustment disorder will typically look different in adults.
An adult going through a bout of adjustment disorder might fall behind in their work, withdraw from friends and family, or maybe even partake in risky behavior, like excessive spending.
Adjustment Disorder and Its Differing Forms
It’s rare for adjustment disorder to show up alone. More often than not, sufferers of the condition will experience it with comorbidities.
Here are a few adjustment disorder subtypes.
Adjustment Disorder with Depression
One of the more common expressions of adjustment disorder is a depressive one. What makes adjustment disorder with depressed mood different from other forms of depression is an identifiable cause. When being diagnosed with more long-standing depression, there is no need for an external trigger.
Still, adjustment disorder with depressive mood can seriously impact daily functioning--even in the short-term. Some may find themselves having trouble sleeping, neglecting personal hygiene, losing interest in personal interests, etc.
When these symptoms arise, it’s incredibly important to consult with a therapist. Without proper intervention, this adjustment subset can turn into MDD--better known as Major Depressive Disorder. Here, there is an increased risk of self-harm and suicide.
Adjustment Disorder with Anxiety
On the other side of the same coin, there’s an anxious expression of adjustment disorder. Like other forms of anxiety, adjustment anxiety can make tasks expected of us difficult, if not impossible.
When starting a new job or moving to a new city, some may find themselves frozen with fear. That fear might manifest itself generally, socially, or even through a bout of impostor syndrome.
One of the most challenging parts of anxiety is the mental space it takes up. Constant worry, insecurity, and fear can be challenging to tolerate. Adding intrusive thoughts to the equation makes thriving in new environments and connecting with others (even our loved ones) unbearable.
Adjustment Disorder with Disturbance of Conduct
This version of adjustment disorder involves what psychologists call ‘deviant behavior’. It involves violating the rights of others and going against social norms. A few examples of conduct disturbance would be fighting, cheating on a spouse, and reckless driving.
Deviant behaviors associated with adjustment disorder are concerning because they could have dire consequences. While anyone could develop these symptoms, it’s more likely that children and adolescents will.
If truancy or fighting is involved, there is a risk of school suspension or being held back a grade-level. For adults, the stakes might be higher. Since deviant behavior refers to behavior not aligned with social norms, it’s often associated with criminality and risky behavior. This could potentially mean putting one’s job in jeopardy or even committing misdemeanors.
Our acute reactions to stress are personal and may not fit into a neat subcategory. Because of this, some adjustment disorder comorbidities join the subsets listed above.
It’s not uncommon for sufferers to be diagnosed with Adjustment Disorder with Depression and Anxiety, where there is a combination of anxious and depressive symptoms.
The same goes for Adjustment Disorder with Mixed Disturbance of Emotion and Conduct. Here, there are both emotional and behavioral challenges that arise. Patients seeking treatment may very well be dealing with depressive, anxiety, and abnormal behaviors.
In Adjustment Disorder with Other Specified Symptoms, responses to stressful events do not fit into any category but are still disproportionate to the circumstance.
Help Is Out There
When it comes to treating adjustment disorder, therapy has been the most effective route. In this case, treatment is usually short-term but could be extended if need be. Cognitive Behavioral Therapy is particularly well-suited for adjustment disorders because of its orientation towards mindfulness.
Depending on the stressors and individual needs, sufferers may decide to either try individual or group therapy. There are benefits to each, so participating in both may also be beneficial.
Family therapy could help parents create supportive environments for children and adolescents to move their children past the stressful trigger.
Adjustment Disorder is temporary, but why suffer through it for any longer than you have to? There are some great options to make transitions feel more manageable--so what are you waiting for? Lean on supports and look for a trusted professional to help you feel in control and confident. So when these things pop-up in the future, you’ll have all the tools you need to fly through them!