An adjustment disorder occurs when a person experiences a stressful situation and then suffers from significant distress and emotional symptoms that seem out of proportion to the severity of the stressful situation. Adjustment disorders can be misunderstood and there are some common adjustment disorder myths. Learning the facts about adjustment disorder can promote a greater understanding of this mental health condition.
Myth 1: There’s only one type of adjustment disorder
Fact: Adjustment disorder is a term that describes six specific types of adjustment disorders.
There is more than one type of adjustment disorder, based on the predominant symptoms presented by the patient. The types of adjustment disorders are as follows, according to the Substance Abuse and Mental Health Services Administration (SAMHSA):
- With depressed mood
- With anxious mood
- With mixed anxiety and depressed mood
- With disturbance of conduct
- With mixed disturbance of emotions and conduct
In an adjustment disorder with depressed mood, a person may feel blue and hopeless, whereas with an anxious mood, people feel nervous and worried. In a mixed adjustment disorder a person experiences both symptoms of depression and anxiety. When there is a disturbance of conduct, a person might violate rules or laws. With mixed disturbance of emotions and conduct a person violates rules and also experiences emotional symptoms like depression or anxiety. An unspecified adjustment disorder does not fit into any of the other five categories.
Myth 2: Adjustment disorder is long lasting
Fact: Adjustment disorder is not a long-term mental illness.
Adjustment disorder typically presents within three months of experiencing a stressful situation and it resolves within six months. Unless the stressor is ongoing, adjustment disorder resolves relatively quickly.
According to doctors from Johns Hopkins Medicine, adjustment disorder can occur immediately and be brief when someone is faced with a short-term issue, such as losing a job. The consequences of such an action tend to pass quickly, so the adjustment issues are shorter lasting. On the other hand, adjustment disorder duration can be longer when a stressor is ongoing, such as when a person is dealing with a long-term illness. Since adjustment disorder is not a long-lasting mental illness, symptoms typically resolve within six months of the stressor ending.
Myth 3: Adjustment disorder is the same as PTSD
Fact: Adjustment disorder and PTSD are two distinct mental health diagnoses.
Both adjustment disorder and PTSD involve behavioral symptoms in response to a stressful event, but the difference between adjustment disorder and PTSD is that with adjustment disorder, a person has a reaction that seems out of proportion to the intensity of the event. For example, the anxiety or depression that one experiences with adjustment disorder is more severe than the typical person would demonstrate in reaction to a similar event. With PTSD, a person is displaying a reaction to a significantly traumatic event, such as sexual abuse or witnessing a natural disaster or life-threatening situation.
There are also different symptoms with adjustment disorder vs. PTSD. Adjustment disorder symptoms include emotions and behaviors such as depression, anxiety, or disregard for rules, and these symptoms interfere with functioning at work and/or home. In PTSD, a person experiences the following symptoms:
- Flashbacks of a traumatic event
- Unpleasant dreams
- Intrusive thoughts
- Avoidance of thoughts about the event
- Avoidance of things that represent the event, such as the location it occurred.
- Feelings of tension
- Angry outbursts
- Being easily startled
- Sleep disturbances
- Lack of interest in favorite activities
- Feelings of guilt
- Difficulty remembering details of the traumatic event
The different symptoms between adjustment disorder and PTSD demonstrate that the two are separate mental health conditions.
Myth 4: Adjustment disorders are only triggered by negative stressors
Fact: Both negative and positive stressors can result in an adjustment disorder.
Stress and adjustment disorders go hand-in-hand. Negative stressors, such as financial difficulties or a serious illness are often associated with adjustment disorders, but even positive events can become stressful and cause difficulties with adjustment. For example, positive stressors such as going away to college, having a child, or entering retirement can produce difficulties with adjustment.
While positive events, such as going to college, are exciting, they do represent a significant change of routine, and some people may struggle to adapt to this. In addition, some people might find that positive stressors like childbirth come along with unexpected challenges. This can result in difficulties with adjustment and feelings like anxiousness and depression.
Myth 5: Adjustment disorders aren’t that serious
Fact: An adjustment disorder is a diagnosable mental health condition that should be taken seriously.
It might seem like adjustment disorders are simply a normal reaction to a stressful event, but they represent a mental health condition that requires treatment. Adjustment disorders are associated with anxiety and depression, and adjustment disorder with suicide ideation can also occur. Experts report that having an adjustment disorder increases the risk that someone will attempt and complete suicide, indicating that there can be serious consequences with this type of diagnosis.
Treatment is necessary to prevent serious consequences with adjustment disorder and psychotherapy, or counseling, is the preferred adjustment disorder treatment. In psychotherapy, people can learn coping skills and identify solutions for managing the effects of the stressor that has resulted in an adjustment disorder.
If you or a loved one is experiencing an adjustment disorder and a co-occurring addiction, The Recovery Village has locations around the country and offers comprehensive treatment services that can address both conditions. Contact admissions today to explore treatment options.
Substance Abuse and Mental Health Services Administration. “DSM-IV to DSM-5 adjustment disorders comparison.” June 2016. Accessed June 4, 2019. U.S. National Library of Medicine. “Adjustment disorder.” March 26, 2018. Accessed June 4, 2019. Lal, Rachna, and Mackinnon, Dean. “Adjustment disorder.” John Hopkins Medicine, October 29, 2017. Accessed June 5, 2019. National Institute of Mental Health. “Post-traumatic stress disorder.” (n.d.) Accessed June 5, 2019.
Substance Abuse and Mental Health Services Administration. “DSM-IV to DSM-5 adjustment disorders comparison.” June 2016. Accessed June 4, 2019.
U.S. National Library of Medicine. “Adjustment disorder.” March 26, 2018. Accessed June 4, 2019.
Lal, Rachna, and Mackinnon, Dean. “Adjustment disorder.” John Hopkins Medicine, October 29, 2017. Accessed June 5, 2019.
National Institute of Mental Health. “Post-traumatic stress disorder.” (n.d.) Accessed June 5, 2019.