Adjustment Disorders

Adjustment disorders are psychiatric disorders of the development of the response to a number of normal stressful conditions and present with various symptoms based on the adjustments to these stress conditions. There is no particular amount or characteristic type of stress known to induce it. Any kind of stress can cause these adjustment disorders. These are more commonly seen in younger persons. These are the emotional and behavioral symptoms in response to the known stressful event that occurs within 3 months of the stressor.

These patients are usually sad, do not show interest in any activities, always worried but these are different from depression. But can be more common in a person who has a suicidal tendency. These can be seen by any person. These mainly occur whenever there is difficulty in coping with situations such as accidents, death of loved ones, sudden loss of property, fired from work, etc. not everyone has this depending on the person’s acceptance of the situation some people may develop it.

Adjustment disorders usually resolve on their own in 6 months as the person starts accepting the reality, but they should be treated with medications or therapy.

Adjustment Disorders Causes

Many theories have been suggested for cause the of adjustment disorders. These theories include −

  • Theory of psychological vulnerability − In this, the strength of the person determines the kind of adjustment to a stressor.

  • Associative network formation theory − adaptation develops following the stress-causing event but associated stimulus information about the stressor can determine the type of adaptation

  • Contemporary psychodynamic theory − in this when the person is trying to realize the stressful event and trying to cope with it and when the surrounding people criticize, reject or neglect the person and are left alone then it leads to a symptom adaptation.

  • The stressful event − Accidents, death of loved ones, sudden loss of property, fired from work, relationship issues or divorce, any severe health issues, family fights or problems in school in case of children, etc.

Adjustment Disorders Symptoms

Common symptoms of adjustment disorders include

  • Mood changes usually feel depressed

  • Low self-confidence

  • Thoughts about suicide

  • Increased motor activity

  • Addiction to alcohol, smoking, or any substance abuse

  • Thinking about revenge

  • Reduced interest in any activities

Additional symptoms of adjustment disorders include −

  • Feeling of helplessness

  • Self-blaming

  • Reject to take help

  • Aggregation loss of appetite

  • Disturbances in the sleep

  • Suicidal thoughts

Adjustment Disorders Risk Factors

Anyone and everyone can get this in extremely stressful situations. Everyone faces different stressful activities on regular basis. No one is thought to handle stress in a particular way so reaction varies from person to person. Some things may affect a person to a larger extent whereas the same things may not affect some people at all. Family and friends support matters in certain situations to cope with the stress.

Some of the risk factors which increase the risk include −

  • History of previous episodes

  • People having drug abuse

  • Trauma

  • People who are not optimistic and have higher impossible expectations and unattainable goals

  • Sleep disorders

  • Alcohol and drug addiction

  • Lack of coping skills as in people who have never faced severe stressful situations before

Adjustment Disorders Diagnosis

The diagnosis of adjustment disorders is based on the criteria given by DSM 5. The criteria include the following −

  • The change in emotional or behavioral response occurs within 3 months of the onset of the stressful situation

  • The behavior is significantly evident as extreme sadness or agitation out of proportion to the situation that happened and noticeable impairment in occupational, social, or other important areas of functioning.

  • The stress-related symptom which has occurred does not suggest any other mental disorder or it is not an increase in the previously present disorder

  • The symptoms do not represent the normal behavior

  • Once the stress is removed the symptoms do not persist for more than 6 months

  • The person can be in a depressed mood, with anxiety, with both mixed anxiety and depression, with disturbance of conduct, with both disturbances of conduct and emotions, or unspecified.

  • The diagnosis is also made based on criteria given by ICD 10. According to this, the response develops within 1 month of the stressful situation, which interferes with social and functional performance and with routine activities.

Adjustment Disorders Treatment

The treatment of adjustment disorders mainly aims at reducing the symptoms and achieving an adaptive state which is better than the actual response. Treatment is required for a short duration as it is a temporary condition. The treatment includes −

  • Psychotherapy

  • Crisis intervention

  • Family and group therapies

  • Support groups

  • Cognitive behavioral therapy

  • Interpersonal therapy

  • Pharmacological therapy −Drugs are used to treat depression, anxiety, and lack of sleep. Drugs like benzodiazepines, selective serotonin receptor inhibitors and anxiolytics such as gabapentin are given.

Adjustment Disorders Prevention

Some of the preventive measures for adjustment disorders include −

  • Having a healthy lifestyle: Proper diet, sports activity, sleep

  • Interacting with family and friends, developing a good network of people to support.

  • Helping people to talk about the problems

  • Focusing on how to emotionally cope and solve problems

  • If at work or at school if any individual is noticed to have the symptoms should be referred to a psychologist.


Adjustment disorders are the developmental response to various stressful situations which are out of proportion to the stress caused; hence these interfere with one’s social, occupational, and routine activities. These can present with various symptoms such as depression, aggregation, sleep disturbances, and so on.

It is a mental condition where one should be positive and courageous to cope with stressful events and also the support of close people plays a role in coping with the stress. Certain medications can also be given to help the person to come out of stress.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha