Signs & Effects of Adjustment Disorder

Learn about adjustment disorder

Resulting in emotional or behavioral responses to a single event or multiple stressors, adjustment disorder is known to cause significant impairment is several areas of a person’s daily functioning. Be it divorce, a natural disaster, or recurring stress, such as a degenerative medical condition, adjustment disorder is characterized by anguish that is out of proportion to the severity of the triggered stress. Not to be confused with the normal stages of grief, a person with adjustment disorder displays grief reactions beyond what is accepted culturally, religiously, or as appropriate for an individual’s developmental age.

Beginning three months after the initial stressor or event, and lasting no longer than six months, adjustment disorder can stem from life events such as leaving one’s parental home for the first time or getting married. However, a stressful acute event, such as getting fired from a job or the sudden death of a loved one, can trigger symptoms of the disorder immediately.

Adjustment disorder statistics

Research has shown that people receiving treatment in an outpatient mental health setting are diagnosed with adjustment disorder 5-20% of the time. However, those receiving inpatient mental health treatment obtain an adjustment disorder diagnosis around 50% of the time. Lastly, it is important to note that adults with the disorder are more prone to an emotional response to stressors, while children and adolescents have a greater likelihood to present with acting out behaviors.

Causes and risk factors for adjustment disorder

The specific identifiable cause of adjustment disorder has yet to be realized by researchers. However, many mental health professionals agree that genes, changes in brain chemistry, and influences from a person’s environment can play a role in the development of adjustment disorder. The following dynamics have been shown to contribute to an eventual diagnosis:

Genetic: Those who are genetically predisposed to other mental illnesses or certain medical conditions could be more susceptible to adjustment disorder. Mental illnesses, which are known to have genetic ties, such as anxiety, could cause an adverse and subsequent extreme response to a life stressor.

Physical: Experiencing trauma has the potential to alter one’s brain chemistry. Activating the brain’s fight or flight response and causing a surge of neurotransmitters when in distress, especially if done on a frequent basis, can change a person’s emotional and behavioral response due to this chemical change. Susceptibility to adjustment disorder is then increased as the individual’s ability to respond normally to stress is hindered.

Environmental: Repeated exposure to environmental stress can result in an adjustment disorder diagnosis. Residing in a high-crime area or witnessing domestic violence are both examples of recurrent traumas. Moreover, a experiencing a single severe environmental event, like a natural disaster, can bring about symptoms concurrent with adjustment disorder.

Risk Factors:

• Experiencing the loss of a loved one
• Ending an intimate relationship
• Having another mental disorder
• Lacking social skills
• Lacking appropriate coping skills
• Being a victim of assault, abuse, and/or neglect
• Surviving a natural disaster
• Being diagnosed with a progressive medical condition
• Experiencing a traumatic event
• Repeated exposure to violence
• Experiencing a major life change (e.g., getting married, moving out-of-state, etc.)

Signs and symptoms of adjustment disorder

The signs and symptoms of adjustment disorder can vary person to person. Depending on the triggering stressor(s) that led to onset, the person’s ability to cope, and the level of impairment experienced, the following signs and symptoms can manifest in a person suffering from adjustment disorder:

Behavioral symptoms:

• Disinterest in activities once enjoyed prior to the stressor(s)
• Being argumentative
• Using and/or abusing substances
• Vandalism
• Demonstrating lack of impulse control
• Tearfulness
• Strong desire to be alone
•  Being defiant
• Missing work and/or school

Physical symptoms:

• Inability to sleep
• Heart palpitations
• Chest pains
• Headaches
• Stomachaches
• Fatigue
• Muscle tension
• Nausea
• Appetite changes
• Diarrhea

Cognitive symptoms:

• Lack of concentration
• Inability to commit to plans
• Feeling overwhelmed
• Trouble with memory

Psychosocial symptoms:

• Increased levels of stress
• Separation anxiety
• Increased anxiety
• Inability to experience pleasure
• Hostility
• Feelings of desperation
• Unstable mood
• Suicidal thoughts
• Hopelessness
• Depressed mood
• Aggressive outbursts

Effects of adjustment disorder

Symptoms of adjustment disorder can have short and long-term effects on a person’s life without proper treatment. And while these symptoms tend to dissipate after about six months, without treatment, adjustment disorder can result in the following effects:

• Social withdrawal or isolation
• Family discord
• Decreased performance at work or school
•  Change in interpersonal relationships
• Complications in medical conditions
• Substance use
• Self-injury
• Suicidal attempts
• Development of other mental health disorders
• Loss of employment

Adjustment disorder and co-occurring disorders

While adjustment disorder often accompanies a progressive medical illness, other mental health disorders are frequently diagnosed at the same time as adjustment disorder. Examples of mental illness that are co-occurring are:

• Depressive disorders
• Mood disorders
• Anxiety disorders
• Phobias
• Conduct disorder
• Selective mutism
• Eating disorders
• Learning disorders
• Attention deficit/hyperactivity disorder
• Oppositional defiant disorder