What is Adjustment Disorder?

Change is an inevitable and natural part of life: we change jobs, homes, and hobbies, gain and lose friends and partners, adopt a dog, move to a new town. Some changes are welcome while some may be less so, and adapting to change is a key part of mental well being. When a life change creates ongoing and significant distress, “adjustment disorder” may exist. Clinically, adjustment disorder is when a person feels more stress, sadness, anger, or physical symptoms than one may expect and these symptoms occur within three months of the stressor.

I most frequently encounter adjustment disorder when major family changes occur. For children and adults, this is generally due to divorce or a family member leaving the family in some sense (moving away, being hospitalized, entering the penal system, or facing deportation). Children in particular struggle with such adjustments: children thrive on stability and breaking healthy attachments and disrupting their conception of family can be difficult. Children often act out in these instances and become irritable or angry, or isolate from family members-both remaining ones in the home as well as those have separated. In times of divorce, I frequently hear concerns from the parent who remains in the home that the child is acting out and appears angry with them. It can be helpful to understand that children express anger when they are unable to express underlying emotions, such as sadness or worry. When a child is struggling with adjustment disorder, anger is often an easier emotion to access and express. Children and adults frequently also have physical symptoms of adjustment disorder. These may include headache, over or under eating, sleeping more or less, and body pain. Some refer to adjustment disorder as “situational depression” and its symptoms are similar to those of depression.

If you or your child are struggling with adjustment disorder, there are several options for treatment. Keeping with a routine can be very helpful: try and promote some stability and similar activities as prior to the change. Continue or begin taco nights, yoga classes, family game nights, and reading at bedtime. When focused on individual therapy, I remind patients to take care of themselves: try and get enough sleep, exercise, and eat well while incorporating fun activities, and be mindful of self-medicating. For child therapy, books can be a great resource for helping them understand changes. There are some great age-appropriate therapeutic books on divorce, changing homes, foster care, new schools, and any number of subjects. A therapist can also help to process feelings and help identify positive ways to tackle new changes. While adjustments are inevitable, they can be managed and there is a great future out there!

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