Diseases & Conditions

Adjustment disorders

Work problems, getting married, going away to school, an illness — any number of life changes can cause stress. Most of the time, people adjust to such changes within a few months. But if you continue to feel down or self-destructive, you may have an adjustment disorder.

An adjustment disorder is a type of stress-related mental illness. You may feel anxious or depressed, or even have thoughts of suicide. You may not be able to go about some of your daily routines, such as work or seeing friends. Or you may make reckless decisions. In essence, you have a hard time adjusting to change in your life, and it has serious consequences.

You don't have to tough it out on your own, though. Treatment of an adjustment disorder may help you regain your emotional footing. Most adults get better within just a few months, although teenagers may struggle longer. Treatment may also help prevent an adjustment disorder from becoming a more serious problem.

The signs and symptoms of adjustment disorders vary from person to person. The symptoms you have may be very different from those of someone else with an adjustment disorder. But for everyone, symptoms of an adjustment disorder begin within three months of a stressful event in your life.

Emotional symptoms of adjustment disorders
Signs and symptoms of adjustment disorder may affect how you feel and think about yourself or life, including:

• Sadness
• Hopelessness
• Lack of enjoyment
• Crying spells
• Nervousness
• Thoughts of suicide
• Anxiety
• Worry
• Desperation
• Trouble sleeping
• Difficulty concentrating
• Feeling overwhelmed

Behavioral symptoms of adjustment disorders
Signs and symptoms of adjustment disorder may affect your actions or behavior, such as:

• Fighting
• Reckless driving
• Ignoring bills
• Avoiding family or friends
• Poor school or work performance
• Skipping school
• Vandalism

Length of symptoms
How long you have symptoms of an adjustment disorder also can vary:

• Six months or less (acute). In these cases, symptoms may go away on their own, especially if you actively follow self-care measures.
• Longer than six months (chronic). In these cases, symptoms continue to bother you and disrupt your life. Professional treatment can help symptoms improve and prevent the condition from continuing to get worse.

When to see a doctor
Sometimes the stressful change in your life goes away, and your symptoms of adjustment disorder get better on their own. But often, the stressful event remains a part of your life. Or a new stressful situation comes up, and you face the same emotional struggles all over again.

You may think that an adjustment disorder is less serious than other mental health problems because it involves stress, but that's not necessarily true. Adjustment disorders can affect your whole life. You may feel so overwhelmed, stressed and hopeless that you can't go about your normal daily activities. You may skip work or school, for instance, or not pay your bills. You may drive dangerously or pick fights.

People with adjustment disorders also may abuse alcohol or drugs, engage in violence, and have thoughts of suicide. If you or a loved one has suicidal thoughts or is seriously considering hurting someone, seek help immediately.

Talk to your doctor if you're having trouble getting through each day. You can get treatment to help cope better with stressful events and feel better about life again.

People of all ages are affected by adjustment disorders. Among children and teenagers, both boys and girls have about the same chance of having adjustment disorder. Among adults, women are twice as likely as men to have adjustment disorder. But researchers are still trying to figure out what causes adjustment disorders. As with other mental disorders, the cause is likely complex and may involve genetics, your life experiences, your temperament and even changes in the natural chemicals in the brain.

Most people find treatment of adjustment disorder helpful, and they're in treatment only for several months. Others may benefit from longer treatment, though. There are two main types of treatment for adjustment disorder — psychotherapy and medications.

Psychotherapy
The main treatment for adjustment disorders is psychotherapy, also called counseling or talk therapy. You may attend individual therapy, group therapy or family therapy. Therapy can provide emotional support and help you get back to your normal routine. It can also help you learn why the stressful event affected you so much. As you understand more about this connection, you can also learn healthy coping skills. These skills can help you weather other stressful events that may arise in your life.

Medications
In some cases, medications may help, too. Medications can help with such symptoms as depression, anxiety and suicidal thoughts. Antidepressants and anti-anxiety medications are the medications most often used to treat adjustment disorders. As with therapy, you may need medications only for a few months.

When you face a stressful event or major life change, you can take some steps to care for your emotional well-being. Do what works for you. Some examples include:

• Talking things over with caring family and friends
• Trying to keep eating a healthy diet
• Sticking to a regular sleep routine
• Getting regular physical activity
• Engaging in a hobby you enjoy
• Finding a support group geared toward your situation
• Finding support from a faith community

If it's your child who's having difficulty adjusting, you can help by:

• Offering encouragement to talk about his or her feelings
• Offering support and understanding
• Reassuring your child that such reactions are common
• Touching base with your child's teacher to check on progress or problems at school
• Letting your child make simple decisions, such as what to eat for dinner or which movie to watch

If you use these kinds of self-care steps but they don't seem to be helping, be sure to talk to your health care provider.