Adjustment Disorders

Adjustment disorders (ADs) are a frequent diagnosis in the clinical field.  ADs are exaggerated responses to identifiable stressors. These responses may be in the form of emotional symptoms (depressed mood, crying, hopelessness, nervousness, etc.) or behavioral symptoms (truancy in children, vandalism, fighting, etc.).  The stressors that lead to ADs are the same sorts that lead to problems in living--marital discord or breakup, the loss of a loved one, relocation, finances, parental rejection, work, substance abuse, and so on. The person with AD reacts more intensely and over a longer period than normal.  This reaction may be because the person is naturally vulnerable or is in a vulnerable stage at the time, or it may be for a different reason altogether.  A person should be diagnosed with an AD only if he or she returns to normal or near-normal within 6 months after the stressor stops.

Also, AD symptoms must begin within 3 months of the occurrence of the stressor. As with other diagnosable mental disorders, AD must produce significant impairment in some aspect of life, or distress severe enough to merit clinical attention. The stressor cannot be the recent death of a loved one, unless the symptoms are so severe or are lasting so long that it is beyond what would be considered normal bereavement.  

DSM-IV codes ADs into six subtypes that have different predominant symptoms. They are: 1) With depressed mood, 2) With anxiety, 3) With mixed anxiety and depressed mood, 4) With disturbance of conduct, 5) With mixed disturbance of emotions and conduct, and 6) Unspecified.

When discussing therapy for people with ADs, Maxmen and Ward¹  give arguments for (therapy can provide support and may hasten recovery) and against (therapy costs money and time, and most persons will improve anyway) putting people with ADs into treatment. Certainly the pros and cons must be balanced by those who need to make decisions about therapy. However, the advantages of seeking therapy are likely to very clearly outweigh the disadvantages if the AD is leading to family conflict, which in turn may worsen and prolong the problems if it is not treated.

If you or someone you love experiences enough of these symptoms to feel upset about it, you need to consult a mental health professional (clinician, therapist). A mental health professional  will conduct a thorough evaluation  to first understand what is happening and then will discuss treatment options, including medications.

There are many ways family members or loved ones can help individuals to deal with the disorder better. You can consult another brief discussion of ADs at this UK web site.