Adjustment
Adjustment Disorder is a stress-related mental health condition that occurs when your emotional or behavioral responses to a major life change or difficult event become overwhelming and start to interfere with daily life. Examples of common stressors include the end of a relationship, moving to a new city, starting or losing a job, experiencing illness or injury, or major changes in family dynamics.
Adjustment to a stressor can be a process and ongoing. These situations often bring up very real feelings of sadness, worry, frustration, or even hopelessness. For many people, these reactions are temporary. They may feel unmotivated, distracted, or emotionally raw, but over time, those feelings begin to ease. They may rely on support systems, coping strategies, or simply the passage of time to help them adjust. It’s normal to feel emotionally off balance when life changes unexpectedly.
However, when emotional responses to a life change are more intense than expected—or they last longer than a few months and begin to affect your ability to function—this may be a sign of Adjustment Disorder. Symptoms might include excessive sadness or anxiety, difficulty sleeping or focusing, withdrawing from loved ones, or acting out through impulsive or disruptive behavior. These experiences can be deeply distressing and may not meet criteria for other disorders like Major Depression or Generalized Anxiety.
We want to be careful not to pathologize natural reactions to change while also recongizing when someone is stuck and needs support to move forward. Adjustment Disorders are highly treatable, and therapy can offer a safe space to process what’s happening, develop healthy coping tools, and feel more in control again.
For more information, visit the American Psychiatric Association.
All clinicians at Optimal Moments are trained to assess and treat Adjustment Disorder with care, compassion, and evidence-based approaches.
How is Adjustment Disorder different from stress?
It is always best to have a mental health professional conduct an assessment for an accurate diagnosis. We strongly advise against using symptoms presented online through sources like WebMD to diagnose yourself or others. Diagnosis is a complex process best conducted by trained professionals, such as psychologists or clinical social workers or mental health counselors.
Mental health professionals will examine symptoms beyond a checklist to dive deeper into understanding whether the symptoms represent expected nervousness or stress, a specific Anxiety disorder, or are a different condition altogether. Mental health professionals can also recommend a treatment approach that would best address the symptoms and the root causes.
We are looking at a broad picture to understand the full spectrum of symptoms, duration and intensity of the symptoms, potential root causes for the symptoms, and the impact of the symptoms on an individual’s ability to function. Many times, people confuse symptoms of anxiety with symptoms of mania or hypomania and inaccurately assume they have Bipolar, especially if they are experiencing episodes of depression as well. This is a key reason why a professional is best equipped to diagnosis Anxiety disorders.
Stress is a normal part of life. When we experience big changes—starting a new job or school, going through a breakup, moving to a new place—it’s expected that we might feel overwhelmed, anxious, or emotionally unsettled for a little while. These feelings usually fade as we adjust, especially when we have healthy coping tools or support systems in place.
Adjustment Disorder, however, is more than just a stressful reaction. It occurs when your response to a life change feels bigger than expected, lingers longer than it should, or starts to disrupt your ability to function in daily life. You might find that you're stuck in your emotions, unable to “bounce back” the way you normally would. Things that used to feel manageable may now feel exhausting or impossible.
The difference lies in intensity, duration, and impact.
Symptoms of Adjustment Disorder include:
Persistent sadness, tearfulness, or feelings of hopelessness
Feeling anxious, restless, or on edge
Difficulty concentrating or making decisions
Trouble sleeping (too much or too little)
Loss of interest in hobbies or daily activities
Withdrawing from social situations or loved ones
Changes in appetite or energy levels
Irritability, frustration, or angry outbursts
Avoidance of responsibilities (missing work or school)
In children or teens: acting out, defiance, or behavioral changes
What are the causes of Adjustment Disorders?
There isn’t one single cause of Adjustment Disorder. Instead, it’s often the result of a combination of external stressors and internal factors—what’s happening in your environment and how you personally respond to it. Some people are more vulnerable to adjustment difficulties based on their history, personality traits, or current life circumstances.:
Major Life Changes: Sudden or unexpected transitions—like moving, changing jobs, starting school, or becoming a parent—can overwhelm your coping capacity, even if the change is positive.
Adverse Experiences: Difficult experiences such as divorce, illness or injury, job loss, or financial strain are frequent triggers. These events can lead to emotional disorientation and a sense of instability.
Loss and Grief: The death of a loved one, the end of a relationship, or the loss of a sense of identity (e.g., retirement, injury in athletes) can lead to intense emotional responses that don’t resolve easily on their own.
Chronic Stress or Ongoing Conflict: Prolonged exposure to stress—like caregiving, high-pressure work environments, cultural differences, or family conflict—can deplete your resilience over time, making it harder to adapt to new challenges.
Previous Trauma or Adverse Childhood Experiences (ACEs): Individuals with a history of trauma or neglect may find it harder to adjust to new stressors, especially if the current situation reminds them of past pain.
Lack of Support Systems: Going through transitions without a strong social network—friends, family, mentors, or community—can increase the risk of developing Adjustment Disorder.
Personality Traits: People who are highly sensitive, perfectionistic, or prone to worry may have a harder time adjusting to change. This doesn't mean something is wrong with you—just that you might benefit from extra support during stressful periods.
Underlying Mental Health Conditions: Someone with a history of depression, anxiety, or other mental health challenges may be more vulnerable to developing symptoms of Adjustment Disorder in response to life stress.
Sleep: Lack of restful sleep can increase emotional sensitivity and reduce your ability to manage stress. Sleep issues often go hand-in-hand with emotional distress.
What are treatment options for Adjustment Disorder?
Every individual will respond to life changes differently. The symptoms and causes of Adjustment Disorder vary based on your personality, life experiences, support system, and current stressors. Because of this, treatment is not one-size-fits-all. The best place to start is meeting with a mental health professional to develop a treatment plan tailored to your specific situation and needs.
At Optimal Moments, we take a holistic and person-centered approach to treatment and individualize your treatment plan.
Complete Physical: We may recommend working with your PCP and other medical providers to rule out any potential underlying health concerns that could contribute to your emotional or behavioral symptoms, such as hormonal imbalances, chronic fatigue, etc.
Psychotherapy: Our providers use an eclectic approach which includes Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Dialectical Behavioral Therapy (DBT), interpersonal processing, radical acceptance, and other effective therapy techniques.
Lifestyle Modifications: Our providers can work with you on sleep hygiene, stress reduction, establishing a healthy diet, moderate exercise, assertiveness training, career counseling, and other daily lifestyle challenges that may be impacting your mood.
Medications: In some cases, short-term use of anti-anxiety or anti-depression medication may be helpful. Our Psychiatric Mental Health Nurse Practitioner (PMHNP) can assist you in identifying medications to alleviate symptoms. We utilize psychogenetic testing to guide this decision to reduce adverse symptoms and increase the chances of finding the medication that would be best for you.
Community Referrals: We will work with you to identify community resources that may also assist in increasing support. We may discuss support groups, referrals to somatic therapy or career counseling, or family or couples therapy.
The most important thing to remember is you or your loved one do not have to face this alone. We are here to help.
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