Adjustment disorders

A mental health professional can find out if you have an adjustment disorder by talking with you to identify major life stressors, your symptoms and how they affect your ability to live life. You likely will be asked about your medical, mental health and social history.

To help diagnose an adjustment disorder, established guidelines include:

• Having emotional or behavioral symptoms within three months of a specific stressful event.
• Having higher-than-expected stress in response to a stressful life event or having stress that causes a lot of problems in connections with others, or at work or at school.
• Symptoms are not due to another mental health problem or part of the typical grieving process.

Types of adjustment disorders

The guidelines list six types of adjustment disorders:

1. With depressed mood. Symptoms mainly include feeling sad, tearful and hopeless, very tired, and taking no pleasure in the things you used to enjoy.
2. With anxiety. Symptoms mainly include nervousness, worry, having a hard time concentrating or remembering things, and feeling overwhelmed. Children may strongly fear being separated from their parents and loved ones.
3. With mixed anxiety and depressed mood. Symptoms include a blend of depression and anxiety.
4. With disturbed conduct. Symptoms mainly involve behavioral problems, such as fighting or reckless driving. Children and teenagers may skip school or damage or destroy property.
5. With disturbed emotions and conduct. Symptoms include a mix of depression, anxiety and behavioral problems.
6. Unspecified. Symptoms do not fit the other types of adjustment disorders. But this type often includes physical problems, problems with family or friends, or problems at work or school.

Length of symptoms

How long you have symptoms of an adjustment disorder also can vary. Adjustment disorders can be:

• Short term. This is when symptoms last six months or less. These are often called acute symptoms. They should ease once the stressful event passes.
• Long term. This is when symptoms last more than six months. These are often called persistent or chronic symptoms. They continue to bother you and disrupt your life.

Many people with adjustment disorders find treatment helpful, and they often need only brief treatment. Others, including those with persistent adjustment disorders or ongoing stress, may benefit from longer treatment. Treatments for adjustment disorders include talk therapy, medicines or both.

Talk therapy

Talk therapy, also called talk psychotherapy, is the main treatment for adjustment disorders. This treatment can be provided individually, or with a group or as a family.

Therapy can:

• Provide emotional support.
• Help you get back to your typical routine.
• Help you learn why the stressful event affected you so much.
• Help you learn stress management and coping skills to deal with stressful events.

Medicines

Medicines such as antidepressants and anti-anxiety drugs may be used with talk therapy to help with symptoms of depression and anxiety. As with therapy, you may need medicines only for a few months. But do not stop taking any medicine without talking with your health care professional first. If stopped suddenly, some medicines, such as certain antidepressants, may cause physical reactions that make you feel sick.

Here are some steps you can take to care for your emotional well-being.

Resilience is the ability to adapt well to stress, hardships, a disturbing or harmful experience, or tragedy. It's the ability to bounce back after going through a very hard time. Building resilience may vary from person to person, but these strategies can help:

• Stay connected with loved ones and friends who are positive and support you in healthy ways.
• Do something that brings you joy and gives you a sense of accomplishment and purpose every day.
• Live a healthy lifestyle that includes good sleep, a healthy diet and regular physical activity.
• Practice mindfulness, such as through journaling, prayer or yoga.
• Learn from past experiences about how you can make your coping skills better.
• Be hopeful about the future and try to be positive.
• Stay away from alcohol, drugs and other addictive substances.
• Look for and develop your personal strengths.
• Face your fears and accept challenges.
• Work to achieve your goals.
• Plan to handle problems when they occur rather than not face them.

It may help you to talk things over with loved ones and friends. You also can ask for support from a faith community or find a support group for your situation.

If your child is finding it hard to adjust, try gently urging your child to talk about what they're going through. Many parents assume that talking about a hard change, such as divorce, will make a child feel worse. But your child needs to be able to express feelings of grief and hear you tell them that you'll remain a constant source of love and support.

You may start by seeing your primary care professional or a mental health specialist for evaluation and treatment. Here's some guidance to help you prepare for your appointment.

If possible, you may want to take notes during the visit or bring along a family member or friend to help you remember information.

To prepare for your appointment, make a list of:

• Any symptoms you have, how long you've had them, and what makes them better or worse.
• Key personal information, including any major stresses or recent life changes —positive and negative.
• Medical information, including other physical or mental health conditions you have. Include any medicines, vitamins, herbs or other supplements you're taking, and the doses.
• Questions to ask to make the most of your time together.

Some questions to ask include:

• What do you think is causing my symptoms?
• Are there any other possible causes?
• Is my condition likely short term or long term?
• Do you recommend treatment? If yes, with what approach?
• How soon do you expect my symptoms to improve?
• Should I see a mental health specialist?
• Do you recommend any temporary changes at home, work or school to help me recover?
• Are there any brochures or other printed material that I can have?
• What websites do you recommend?

Do not hesitate to ask other questions during your appointment.

Your primary care professional or mental health specialist will ask several questions, such as:

• What are your symptoms?
• When did you or your loved ones first notice your symptoms?
• What major changes have recently occurred in your life — positive and negative?
• How have you tried to cope with these changes?
• How often do you feel sad or depressed?
• Do you think about suicide?
• How often do you feel anxious or worried?
• Do you have trouble sleeping?
• Do you find it hard to finish tasks at home, work or school that you used to be able to manage?
• Are you staying away from social or family events?
• Have you had any problems at school or work?
• Have you made any impulsive decisions or taken part in reckless behavior that does not seem like you?
• Do you drink alcohol or use recreational drugs? If so, how often?
• Have you been treated for other mental health conditions in the past? If yes, what type of therapy was most helpful?

Be ready to answer questions to make sure there's time to go over any points you want to focus on.