Adjustment Disorder

With Anxiety and/or Depression

An Adjustment Disorder occurs when the normal process of adaptation to one or more stressful life experiences is disrupted, and will occur within three months of the onset of this stressor or stressors. These stressors may be perceived as good or bad (see attached Holmes & Rahe scale). AD is not the same as PTSD (post-traumatic stress disorder) which is usually a response to a much more severe stressor.

The disruption will involve being more upset by the stressor(s) than might be expected. This could take the form of anxious feelings, nervousness, worry, feelings of sadness and crying, broken sleep, difficulty in concentrating, muscle tension and fatigue. A person suffering in this way might also withdraw socially, have difficulty working (or attending school or college), or suffer from headaches or stomach-aches.

There does not seem to be a specific ‘type’ of person that suffers in this way and men and women are affected equally. People seem to be at most risk during normal, transitional times and when their lives change a good deal such as in adolescence and in mid or late life. Symptoms generally do not last more than six months. Those lasting longer than this are known as chronic adjustment disorders. Reasons for continuation once the stressor(s) is past might be chronic stress and social and financial problems.

If these feelings persist, perhaps with a need to escape, and unchanging low mood, help should be sought as the problem might be turning in to GAD (General Anxiety Disorder: see leaflet in this series). GAD sufferers worry a great deal about life events, out of all proportion to the problems involved. The onset of major depression might also be a possibility. In such situations a GP or clinician should be consulted.

Treatment of a formal kind is often not necessary, but a GP might recommend intervention by a psychologist or other mental health professional. A person suffering in this way would be well advised to try to understand what is happening and that this is a specific response not just ‘life’. Healthy eating and exercise and a reduction or total avoidance of alcohol and coffee would also be beneficial, as would use of breathing exercises and any of the relaxation and exercise disciplines such as yoga.