Adjustment difficulties & disorders
Adjustment disorder is a clinical diagnosis for one of the most commonly experienced mental health challenges. It occurs when a person experiences distressing emotions or behavior problems in response to a stressful event.
During our lives, we are all exposed to stressful events – conflict in a relationship or moving house, for example. It’s very normal to feel some level of distress following a stressful event. Most of the time, difficult feelings disappear relatively quickly as we adjust.
In the case of adjustment disorder, the distress is more intense and prolonged than what might be typically expected in response to a stressful event.
People with adjustment disorder often struggle with symptoms of depression or anxiety in the months following the stressful event. Symptoms can persist for up to 6 months following the event. During this time, many people find that short-term participation in therapy can help relieve distress.
Prevalence of adjustment disorders
Adjustment disorder is one of the more common mental health diagnoses. A worldwide survey of psychiatrists found that over 50% made the diagnosis at least once per week. (1)
Despite this, it does not appear to be a commonly researched mental health problem and so data about the actual prevalence of the disorder is scarce. The available research suggests that around 1 to 2% of people experience adjustment disorder. (2)
Causes of adjustment disorders
Adjustment disorder is an emotional or behavioral reaction to a stressful event. Some examples of stressful events that might trigger symptoms are:
- Losing a friend or relative
- Relationship problems
- Divorce or separation
- Losing your job
- Conflict at work
- Moving house
- Life transitions
- Financial problems
Unlike post-traumatic stress disorder (PTSD), the stressful event associated with the adjustment symptoms may be of any kind of event of any level of severity.
Symptoms of adjustment disorders
The Diagnostic and Statistical Manual of Mental Disorders (DSM 5) includes adjustment disorder as a diagnosis in the category of trauma- and stressor-related disorders.
People experiencing adjustment disorder may notice some of the following symptoms in response to something stressful in their lives:
- Symptoms of anxiety: Feeling nervous, worried, difficulty concentrating
- Symptoms of depression: Feeling down, tearful, difficulty sleeping, loss of pleasure, irritable
- Behavior problems: Such as getting into fights, being reckless, or other behavior that violates social expectations
- Intense distress, beyond that which might be typically expected in reaction to the stressful event
- Difficulty going about work or school, or other daily activities
The symptoms may start immediately following the stressful event or up to three months after. They do not persist beyond 6 months after the stressful event.
Types of adjustment disorders
There are different subtypes of adjustment disorder listed in the DSM 5; which are:
- Adjustment disorder with depressed mood: The main symptom is low mood or tearfulness.
- Adjustment disorder with anxiety: The main symptom is nervousness or worry.
- Adjustment disorder with mixed anxiety and depressed mood: Symptoms of both anxiety and depression and present.
- Adjustment disorder with disturbance of conduct: Behavioral difficulties are the most prominent symptom.
- Adjustment disorder with mixed disturbance of emotions and conduct: A combination of the above, where mood symptoms of anxiety or depression are experienced in addition to behavioral difficulties.
What to do if you’re experiencing symptoms of adjustment disorders
There are many things you can do to look after your emotional wellbeing following a stressful life event. Consider a combination of the following strategies to help manage distress:
- Therapy: Talk therapies in both individual or group settings can help address symptoms of adjustment disorder. Many people find it helpful to learn coping strategies or different ways of thinking about the stressful event. People typically need only short-term therapy. Therapy types to consider are discussed in more detail below.
- Social supports: It’s important not to isolate yourself. Talk to family and friends; they are an important source or support. They may be able to offer different perspectives that can help change how you think and feel about the stressful event.
- Relaxation: Practice regular relaxation, such as a guided progressive muscle relaxation exercise. This can help with stress management and anxiety.
- Self-care: Pay attention to your diet, try to maintain a regular sleep pattern, and exercise regularly. Find activities that you enjoy, and make time for them in your schedule. Such lifestyle factors can help to regulate our moods. (3,4,5)
- Hotlines: If you’re having thoughts of suicide or need immediate support, call the National Suicide Prevention Hotline at 1-800-273-8255.
Therapy types to consider for adjustment disorders
Many treatment options are available for adjustment disorder, so there’s bound to be an approach that fits well with your personal preferences. Click on the links below to explore which might be the best fit for you. Therapy types include:
- Cognitive Behaviour Therapy (CBT)
- Mindfulness Practices
- Acceptance and Commitment Therapy (ACT)
- Psychodynamic Therapy
- Interpersonal Therapy
- Narrative Therapy
What to look for in a therapist for adjustment disorders
The best-fitting type of therapist for you depends on individual factors, symptoms, your location and finances. It can be helpful to consider the following factors when choosing one:
One of the most important things to consider is the potential for developing a strong working relationship with your therapist. This relationship is called the therapeutic alliance, and it’s the number one indicator of treatment efficacy.
It can be difficult to choose which type of mental health professional to work with, as there are so many different types. Most will have the skills to assist you in the treatment of adjustment disorder.
The main thing to be certain of is that you look for a currently licensed mental health professional. This will ensure that they have undertaken the relevant education to practice. When browsing through therapists on Zencare, you can rest assured that all of our therapists have already been vetted.
In addition, if there is a particular type of therapy that resonates with you, look for a therapist who has completed additional training in the area. Take a look at therapists’ biographies, as this is often where they note their specializations.
Talk in advance
The best way to judge how you might feel about your prospective therapist is to ask for a preliminary phone call. You can do this with our vetted Zencare therapists. Most therapists will be happy to oblige. This gives you the opportunity to ask about:
- Their qualifications
- Their experience working with people who have adjustment disorder
- Any ongoing training they are participating in that relates to your preferred therapy type or adjustment disorder
- What type of therapy they suggest, and what that will be like
- Their participation in insurance plans and cost of therapy
Try to speak to a few different therapists before making your mind up.
Sources and references