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Diagnosis

Diagnosis of adjustment disorders is based on identification of major life stressors, your symptoms and how they impact your ability to function. Your doctor will ask about your medical, mental health and social history. He or she may use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

For diagnosis of adjustment disorders, the DSM-5 lists these criteria:

  • Having emotional or behavioral symptoms within three months of a specific stressor occurring in your life

  • Experiencing more stress than would normally be expected in response to a stressful life event and/or having stress that causes significant problems in your relationships, at work or at school

  • Symptoms are not the result of another mental health disorder or part of normal grieving

Types of adjustment disorders

The DSM-5 lists six different types of adjustment disorders. Although they're all related, each type has unique signs and symptoms. Adjustment disorders can be:

  • With depressed mood. Symptoms mainly include feeling sad, tearful and hopeless and experiencing a lack of pleasure in the things you used to enjoy.

  • With anxiety. Symptoms mainly include nervousness, worry, difficulty concentrating or remembering things, and feeling overwhelmed. Children who have an adjustment disorder with anxiety may strongly fear being separated from their parents and loved ones.

  • With mixed anxiety and depressed mood. Symptoms include a combination of depression and anxiety.

  • With disturbance of conduct. Symptoms mainly involve behavioral problems, such as fighting or reckless driving. Youths may skip school or vandalize property.

  • With mixed disturbance of emotions and conduct. Symptoms include a mix of depression and anxiety as well as behavioral problems.

  • Unspecified. Symptoms don't fit the other types of adjustment disorders, but often include physical problems, problems with family or friends, or work or school problems.

Length of symptoms

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

  • Acute. Signs and symptoms last six months or less. They should ease once the stressor is removed.

  • Persistent (chronic). Signs and symptoms last more than six months. They continue to bother you and disrupt your life.

Treatment

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

Psychotherapy

Psychotherapy, also called talk therapy, is the main treatment for adjustment disorders. This can be provided as individual, group or family therapy. Therapy can:

  • Provide emotional support

  • Help you get back to your normal 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

Medications

Medications such as antidepressants and anti-anxiety drugs may be added to help with symptoms of depression and anxiety.

As with therapy, you may need medications only for a few months, but don't stop taking any medication without talking with your doctor first. If stopped suddenly, some medications, such as certain antidepressants, may cause withdrawal-like symptoms.

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