Effects, Signs & Symptoms of Adjustment Disorder

An adjustment disorder is a short-term emotional or behavioral reaction to a known stressful event or change in a child’s life that is considered maladaptive or an unhealthy, unexpected response to the change or event. The response must occur within three months of the identified stressful change or event in a child’s life and tend to resolve within six months following the event. These events may be something as benign as the birth of a sibling or as life-changing as parental divorce. Other children may have trouble adjusting to a diagnosis of a chronic illness, loss of a pet, or change of schools. Some of the other situations that may lead to adjustment disorder include:

  • Problems in school
  • Breakup of a serious relationship
  • Surviving a disaster
  • Physical assault
  • Death of a loved one
  • Going away to school
  • Sexuality issues
  • Family conflict
  • Social problems

Adjustment disorder is often called “situational depression” as children who have an adjustment disorder may be fearful, hopeless, and lose interest in school or friends. However, unlike major depression, adjustment disorder is triggered by an external stimuli and remits once the child has processed and adapted to the situation. Children and teens do vary in their temperament, past experiences, vulnerability, and coping skills. Their developmental stage and capacity of their support system to meet the needs related to the stress can contribute to the reaction to a life event. Stressors vary in intensity, duration, and effect. There is currently no evidence to suggest a biological component to adjustment disorder.

While some stressful events do resolve on their own and the symptoms of adjustment disorder may dissipate over time, there are a number of repeated stressful situations that cannot be avoided and remain a part of a child’s life. Many people operate under the erroneous conclusion that adjustment disorder is somehow less serious than other mental health problems because it’s a stress-related condition. This isn’t necessarily true. Adjustment disorders can impact every facet of a growing child’s life, leaving them feeling overwhelmed, stressed, hopeless, and unable to complete their normal daily activities. Early recognition and treatment are vital to children who have adjustment disorder as they can work on coping with stress, lifestyle changes, and development of the skills necessary to process their emotions. Treatment can also lessen the likelihood of adjustment disorder creating future problems for your child.

Statistics

Adjustment disorders are a very common occurrence in children and adolescents and occur with equal frequency among boys and girls. Adjustment disorders do occur in all cultures, however cultural influences may impact the type of stressor and symptoms experienced. Children of all ages experience adjustment disorder, however, it’s thought that the symptoms of the disorder will vary between children and adults. Adults may experience a more emotional reaction while children and adolescents often act out.

Causes of Adjustment Disorder

As adjustment disorders are a reaction to stress, there is not a single direct cause between the event and reaction. Factors that may increase a child or adolescent’s development of adjustment disorder include:

Physical: Younger children are less able to cope with strong emotions than older adolescents and adults and are more at risk for developing an adjustment disorder.

Environmental: Low socioeconomic status, living in a crime-stricken neighborhood, and several different types of stresses occurring at the same time can increase the risk for developing adjustment disorder. Additionally childhood abuse of any nature increases the risks for developing adjustment disorder.

If you feel that your child is in crisis, please call 9-1-1 or go to the nearest emergency room immediately.

Symptoms of Adjustment Disorder

As adjustment disorder is based around a particularly stressful event, the symptoms may vary in accordance to proper social support, type of event, and inborn temperament. In all adjustment disorders, the reaction to the specific stressor causes significant impairment in social, occupational, or educational functioning. Some of the symptoms of adjustment disorder may include:

Behavioral Symptoms:

  • Tearfulness
  • Engaging in self-destructive behaviors
  • Withdrawing from friends and previously-enjoyed activities
  • Increasing amounts of time spent alone
  • Increased absences from school
  • Using drugs or alcohol to help combat the feelings of sadness and stress
  • Fighting
  • Acting out

Physical Symptoms:

  • Muscle tension
  • Idiopathic aches and pains
  • Gastrointestinal problems – nausea, vomiting, diarrhea
  • Headaches
  • Changes in appetite and sleep patterns
  • Heart palpitations
  • Fatigue, lack of energy

Cognitive Symptoms:

  • Inability to focus on particular tasks
  • Overwhelmed by demands of school or work

Psychosocial Symptoms:

  • Depressed mood
  • Anxiety
  • Stress
  • Feeling hopeless
  • Mood swings
  • Nervousness
  • Aggressive outbursts
  • Worrying
  • Jitteriness
  • Fear of separation from important figures in child’s life
  • Suicidal thoughts

If symptoms persist past six months or cause marked impairment in your child’s life, do not hesitate to call your child’s doctor for a complete evaluation and treatment recommendations.

Effects of Adjustment Disorder

While most cases of adjustment disorder resolve on their own within six months of the event, some children and adolescents might have long-standing effects caused by adjustment disorder. These may include:

  • Depression
  • Difficulty concentrating
  • Behavioral changes
  • Mood swings
  • Insomnia
  • Social isolation and withdrawal
  • Marital or family conflicts
  • Decreased capacity to work
  • Substance abuse
  • Alcoholism
  • Schizophrenia
  • Bipolar disorder
  • Antisocial personality disorder
  • Self-harm
  • Suicidal thoughts and behaviors