Adjustment Disorder Basics

Adjustment disorder is an unusually strong or long-lasting reaction to a stressful event such as divorce, a death in the family or moving to a new house or school, causing a child to become depressed or anxious, pick fights or refuse to go to school. This guide explains how to recognize the symptoms of adjustment disorder, as well as how it's diagnosed and treated.

Adjustment Disorder: What Is It?

Adjustment disorder is an unusually strong or long-lasting reaction to an upsetting event. The triggering event might be a divorce, a death in the family, moving to a new home, starting a different school, a break up, or a big life disappointment. A child with the disorder will have a hard time coping with his emotions and may become depressed or anxious, exhibit hostility, pick fights, or refuse to go to school, among many possible responses. The disorder is a reaction to an event of great importance to the child — whether or not that event appears significant to others. It can occur in young children, adolescents, and even adults.

Adjustment Disorder: What to Look For

If a child experienced a stressful event and hasn’t been the same since then, he may have adjustment disorder. Signs include that that he is abnormally anxious or depressed, has trouble sleeping, or experiences regular crying spells. Other signs include avoiding school, being isolated from family and friends, irritability, vandalism, and fighting. Common stressful events that trigger adjustment disorders include divorce, moving to a new home, or starting a new school, breaking up with a romantic partner, or, for a perfectionist student, doing poorly in school. In particular, be on the lookout for a reaction that lasts much longer than you would usually expect and significantly interferes with daily life.

Adjustment Disorder: Risk Factors

Children who experience frequent and severe stress are more likely to develop an adjustment disorder.

Adjustment Disorder: Diagnosis

To be diagnosed with adjustment disorder a child will have experienced a stressful event that leaves him abnormally upset and unable to cope. His distress must be more severe than would normally be expected from such an event, and cause significant impairment in academic or social activities. If these symptoms have lasted more than six months after the stressful event, however, it would not be considered adjustment disorder.

Adjustment Disorder: Treatment

Adjustment disorder is primarily treated with psychotherapy, although in some cases medication may also be prescribed to alleviate symptoms.

Psychotherapeutic: Talk therapy is extremely effective in treating adjustment disorder. A therapist might encourage the patient to express emotions in a supportive environment and in a constructive fashion, or suggest that a typical reaction to stress has gotten out of hand but is within his power to control. Another goal of the therapy is to teach him healthier ways of dealing with future stressful situations. Since adjustment disorders often affect the whole family, some sessions might include the parents or other caregivers. Group therapy can also be helpful. A few sessions are usually sufficient for treatment, though occasionally it might take months.

Pharmacological: A doctor may prescribe low doses of anti-anxiety or even neuroleptic medication to help with anxiety and behavior problems. Antidepressants may also be prescribed to treat depressive or suicidal thoughts. In most cases pharmacological treatment is short-lived.

Adjustment Disorder: Risk For Other Disorders

Teenagers with untreated adjustment disorder are at a heightened risk for developing depression, chronic anxiety, and substance abuse problems.