Adjustment disorders can involve problematic feelings and actions in the aftermath of particularly stressful experiences. But doesn’t everyone have difficult when they’re overly stressed? In other words, what is an adjustment disorder, and how is it different from simply struggling a bit after going through tough times?
At Robles Ranch, we can help you determine if what you’ve been dealing with is an adjustment disorder or another challenge. Once we’ve identified the source of the problem, we’ll develop a customized plan to put you back on the path toward a healthier future.
Learn more about mental health treatment in San Luis Obispo County or verify your insurance now.
What Is an Adjustment Disorder?
An adjustment disorder is a mental health condition that is characterized by abnormal emotional or behavioral responses to a one or more specific stressful events or experiences.
In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), adjustment disorders are included in the Trauma- and Stressor-Related Disorders section.
Other conditions in that section include:
- Reactive attachment disorder
- Posttraumatic stress disorder (PTSD)
- Acute stress disorder
- Disinhibited social engagement disorder
Symptoms
One reason why people may ask what is an adjustment disorder is that many of the symptoms can look like common, normal reactions.
For example, when you’ve just ended a relationship, it’s not surprising that you might have difficulty concentrating at work. And if you’re having financial problems or dealing with a serious medical condition, it’s understandable that you might not be sleeping well or have a tendency to become quickly frustrated.
To be clear, the responses described in the previous paragraph are normal and expected. And they’re not necessarily signs of a mental health condition. But if they don’t improve, become more intense, or start to cause additional disruptions your life, that’s when they may cross the threshold that separates temporary emotional pain from a mental health disorder.
DSM-5 Criteria
As established in the DSM-5, symptoms of adjustment disorders must meet two general criteria:
- They must involve marked distress that is “out of proportion to the severity or intensity of the stressor” that triggered their onset.
- They must cause “significant impairment” in a person’s ability to function at work, in school, in social situations, or in other important areas of life.
Also, the symptoms must not be related to another mental health disorder or part of the typical bereavement process.
With those caveats in mind, signs that someone may have an adjustment disorder include:
- Persistent sadness
- Frequent episodes of crying
- Pervasive sense of hopelessness
- Heightened feelings of anxiety or fear
- Difficulty focusing, concentrating, and making decisions
- Diminished confidence and/or self-esteem
- Being easily frustrated or overwhelmed
- Changes in appetite and sleep patterns
- Getting into frequent conflicts with loved ones or colleagues
- Neglecting responsibilities such as paying bills or keeping appointments
- No longer enjoying activities that used to be important to them
- Drop in performance in school or at work
- Pulling away from family and friends
- Thoughts of self-harm or suicide
Specifiers
One of the challenges of diagnosing someone with an adjustment disorder is ruling out disorders with similar symptoms, such as anxiety, depression, or PTSD. In other words, the diagnostic process doesn’t only involve answering the question of what is an adjustment disorder, but also begin able to determine what isn’t an adjustment disorder.
In the case of PTSD, one of the main differences is that adjustment disorder symptoms aren’t usually as intense. Also, PTSD only occurs in the aftermath of traumatic experiences, while adjustment disorders can result from events that most people would view as positive.
In the cases of anxiety and depression, the main difference is that adjustment disorders are tied to identifiable events or experiences. You can be diagnosed with a depressive disorder or an anxiety disorder without having to identify what prompted the onset of your emotional struggles.
Considering that so many adjustment disorder symptoms are similar to other mental or behavioral health concerns, the DSM-5 includes five specifiers to indicate which types of symptoms are having the strongest impact on a person.
Adjustment disorder specifiers in the DSM-5:
- With depressed mood
- With anxiety
- With mixed anxiety and depressed mood
- With disturbance of conduct
- With mixed disturbance of emotions and conduct
- Unspecified
Adjustment disorders can also be categorized as acute or chronic:
- Acute: Symptoms resolve within six months
- Chronic: Symptoms persist for six months or longer
What Causes Adjustment Disorders?
By definition, everyone with an adjustment disorder went through at least one stressful event. Of course, not everyone who goes through the types of experiences listed below develops the condition. There’s no single reason why some do and some don’t, but several factors can influence a person’s risk.
Preceding Events
One may assume that the condition occurs in the aftermath of upsetting or disturbing events. This is only partially true.
While many cases of adjustment disorder can be traced to various painful experiences, sometimes people develop the condition after supposedly happy events that involved significant change.
Examples of events that can precede the onset of adjustment disorder include:
- End of a romantic relationship
- Death of a loved one
- Financial difficulties
- Living in an unsafe environment
- Developing a chronic medical condition
- Moving out of your parents’ house
- Moving back into your parents’ house
- Starting a new job
- Buying a house
- Getting married
- Having your first child
- Being fired from your job
- Retiring
Risk Factors
An August 2017 study in the Asian Journal of Psychiatry found that risk factors for adjustment disorders among may include:
- Age: Adjustment disorders were most common among people ages 15-25.
- Gender: 61.6% of adjustment disorder patients were women.
- Education: Adjustment disorders were most prevalent among patients with more limited education.
- Marital status: Single people were more likely than married people to have an adjustment disorder.
- Residence: 71.2% of patients with adjustment disorder were from urban areas.
Prevalence
The DSM-5 estimates that adjustment disorder may affect as many as 20% of patients who receive outpatient psychiatric care. Additionally, it may affect up to 50% of those who receive inpatient mental health treatment.
An article in the Jan-Mar 2013 edition of the Indian Journal of Psychological Medicine reported the following about the prevalence of adjustment disorders among various populations:
- A review of 1039 referrals from seven teaching hospitals found that 12% of patients were diagnosed with an adjustment disorder.
- A study of patients who were admitted to a psychiatric emergency ward reported that 7.1% of adults and 34.4% of adolescents had an adjustment disorder at time of admission.
- A separate study of psychiatric emergency patients found that 17.7% had adjustment disorders.
- Two reviews of U.S. general hospital patients in the 1980s determined that 13.8% of all patients and 11.5% of psychiatric referrals had adjustment disorder with depressed mood.
- A study from Japan found that 35% of patients who experienced a recurrence of breast cancer developed an adjustment disorder.
The article cited above also included an extremely hopeful statistic. A five-year follow-up of 100 individuals who received treatment found that 71% of adults and 44% adolescents were no longer experiencing symptoms of an adjustment disorder.
Find Treatment for Adjustment Disorders in Paso Robles, CA
If you have been experiencing a severe and persistent negative reaction to a stressful experience, help is available.
Robles Ranch offers a full continuum of personalized programming for adults with adjustment disorders. We also serve clients with co-occurring addictions to alcohol and other drugs.
Treatment options at our center in Paso Robles, CA, include residential care, a partial hospitalization program (PHP), and an intensive outpatient program.
To learn more call 805-635-0668 or verify your insurance now.