A redundancy, a separation, a move, a diagnosis, a new baby, retirement. Big changes are hard for everyone. Most of us feel unsettled for a while, then gradually find our feet. But sometimes the distress is stronger than expected, or it doesn’t ease, and everyday life starts to suffer. When that happens, it may be an adjustment disorder.
What is adjustment disorder?
Adjustment disorder is a strong emotional or behavioural reaction to an identifiable stressor or life change. According to the diagnostic criteria described in the MSD Manual:
- symptoms start within three months of the stressor, often within days
- the distress is out of proportion to the situation, or it’s getting in the way of work, study, relationships or daily life
- symptoms usually ease within six months once the stressor and its consequences have settled.
It’s one of the most common reasons people see a mental health professional. It isn’t a sign of weakness. It’s a sign that you’re carrying more than you can manage alone right now.
Common triggers
- relationship breakdown, separation or divorce (for children, see adjustment to separation and divorce)
- job loss, a new role, or workplace conflict
- moving house, city or country (see immigration and acculturative stress)
- a diagnosis or ongoing health condition (yours or a loved one’s)
- becoming a parent, or children leaving home
- retirement
- for children and teens: changing schools, family separation, or a new sibling.
Signs to look out for
Adjustment disorder can show up in different ways. People often describe it as “adjustment disorder with anxiety”, “with depressed mood”, or a mix of both.
- feeling constantly worried, tense or on edge
- low mood, tearfulness or hopelessness
- trouble sleeping or concentrating
- feeling overwhelmed by everyday tasks
- pulling away from friends or activities
- irritability, or in young people, behaviour changes such as acting out or school avoidance
- thinking about the change constantly, and struggling to move forward.
Adjustment disorder or something else?
The key differences are the clear link to a recent change, and the expectation that things will settle. If symptoms are severe, last well beyond six months, or follow a traumatic event, a psychologist will check for other conditions such as depression, anxiety or PTSD, so you get the right help.
What helps
There’s no single treatment that’s best for everyone, and the research is still growing. What usually helps is a mix of practical support and short-term therapy:
- Talking it through with a psychologist, to make sense of the change and how it’s affecting you.
- Cognitive Behaviour Therapy (CBT) skills to manage worry and unhelpful thinking.
- Problem-solving: breaking the situation into steps you can act on.
- Looking after the basics: sleep, regular meals, movement, and a daily routine.
- Staying connected with people and activities that matter to you.
Some people also see their GP to talk about whether medication might help for a while. Many people need only a few sessions to get back on their feet.
Getting help at MindBox Psychology
Our clinical psychologists in St Leonards see adults, adolescents and children going through difficult life changes. Read more about treatment for adjustment disorder. Sessions are face-to-face or through online counselling anywhere in Australia. You don’t need a referral to book. Medicare rebates may be available with a referral and Mental Health Treatment Plan from your GP or paediatrician. Private health funds and self-managed NDIS may also cover some costs.
If you need help now: call 000 in an emergency, Lifeline on 13 11 14 (24/7), or Beyond Blue on 1300 22 4636.
