Adjustment Disorder (Stress Response Syndrome)

What Is Adjustment Disorder (Stress Response Syndrome)?

Adjustment disorder (stress response syndrome) is a short-term condition that happens when you have great difficulty managing with, or adjusting to, a particular source of stress, such as a major life change, loss, or event. In 2013, the mental health diagnostic system technically changed the name of "adjustment disorder" to "stress response syndrome."

Because people with stress response syndrome often have some of the symptoms of clinical depression, such as tearfulness, feelings of hopelessness, and loss of interest in work or activities, adjustment disorder is sometimes informally called "situational depression."

Adjustment Disorder vs. Major Depression

Adjustment syndrome/stress response syndrome has some symptoms that overlap with those of major depression. Unlike major depression, an adjustment disorder doesn't involve as many of the physical and emotional symptoms of clinical depression (such as changes in sleep, appetite, and energy) or high levels of severity (such as suicidal thinking or behavior).

Adjustment Disorder vs. Posttraumatic Stress Disorder (PTSD)

An adjustment disorder/stress response syndrome is not the same as posttraumatic stress disorder (PTSD). PTSD is a reaction to a life-threatening event that happens at least 1 month after the event, and its symptoms tend to last longer than in adjustment disorders/stress response syndromes. By comparison, adjustment disorders/stress response syndromes rarely last longer than 6 months.

Symptoms of Adjustment Disorder/Stress Response Syndrome (AD/SRS)

Adjustment disorder/stress response syndrome changes the way you feel and think about the world and your place in it. A person with AD/SRS has emotional and/or behavioral symptoms as a reaction to a stressful event. These symptoms generally begin within 3 months of the event and rarely last for longer than 6 months after the event or situation has ended.

In adjustment disorder/stress response syndrome, the reaction to the stressor is greater than what is typical or expected for the situation or event. The symptoms may cause problems with a person's ability to function; for example, the person may have trouble with sleep, work, or studying. It can have a wide variety of symptoms that are changes from someone's usual self, which may include:

• Feeling of hopelessness
• Sadness
• Frequent crying
• Anxiety (nervousness)
• Worry
• Headaches or stomachaches
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• Withdrawal or isolation from people and social activities
• A new pattern of absence from work or school
• New and out-of-the-ordinary dangerous or destructive behavior, such as fighting, reckless driving, and vandalism
• Changes in appetite; either loss of appetite or overeating
• Problems sleeping
• Feeling tired or without energy
• Using alcohol or other drugs more

Symptoms in children and teens tend to be more behavioral in nature, such as skipping school, fighting, or acting out. Adults, on the other hand, tend to have more emotional symptoms, such as sadness and anxiety.

AD/SRS Causes and Risk Factors

AD/SRS is very common and can affect anyone, regardless of gender, age, race, or lifestyle. Although an adjustment disorder can occur at any age, it is more common at times of major transitions, such as adolescence, midlife, and late life.

The type of stress that can trigger an adjustment disorder/stress response syndrome varies depending on the person, but can include:

• Ending of a relationship or marriage
• Losing or changing a job
• Death of a loved one
• A serious illness (yourself or a loved one)
• Being a victim of a crime
• Having an accident
• Having a major life change (such as getting married, having a baby, or retiring from a job)
• Living through a disaster, such as a fire, flood, or hurricane

Diagnosing AD/SRS

If you suspect you may have an AD/SRS, see your doctor. If you have symptoms, your doctor may do a physical exam and ask questions about your medical and mental health histories. Although there are no imaging or lab tests to specifically diagnose the syndrome, the doctor may sometimes use laboratory tests -- such as blood or imaging tests like CT or MRI scans -- to rule out physical illness or other medical causes of changes in mood or behavior (such as head trauma) as the cause of your symptoms.

If AD/SRS is suspected, your doctor will likely refer you to a psychiatrist, psychologist, or other mental health professional who is trained to help people when they have trouble coping with and managing stressful life events. They’ll look for other mental illnesses, such as posttraumatic stress disorder, major depression, or an anxiety disorder.

Your doctor will diagnose you with AD/SRS based on the criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM–5):

• A change in emotional or behavioral symptoms that happens within 3 months of a stressful event in your life
• Showing a level of distress that’s more intense than would normally be expected in response to what happened
• Having significant problems in your personal life and/or at work or school
• Symptoms that aren’t related to another illness or mental health disorder

AD/SRS Treatment and Home Care

If you have symptoms of AD/SRS, it is important that you seek medical care. Adjustment disorder can sometimes turn into major depressive episodes in people who are at risk for getting mood disorders. If you turn to alcohol or drugs to manage your stress and anxiety, you may develop a substance abuse problem.

Treatment for AD/SRS may include:

• Psychotherapy or talk therapy
• Medications, including antidepressants or anti- anxiety drugs
• Support groups

You can also take steps to build your resilience and feel better. Try these tips:

• Connect with friends and family.
• Find activities that give you purpose.
• Eat right and exercise.
• Sleep well.
• Work on your coping skills.
• Have a positive attitude.
• Recognize and build your strengths.
• Face your fears.
• Work to problem- solve.

Most people with adjustment disorder/stress response syndrome recover completely. In fact, a person who is treated for adjustment disorder/stress response syndrome may learn new skills that actually allow them to function better than before the symptoms began.

AD/SRS Prevention

There is no known way to prevent adjustment disorder/stress response syndrome. But strong family and social support can help a person work through a particularly stressful situation or event. The best prevention is early treatment, which can teach new coping skills, make symptoms less severe, and cut how long your symptoms last.

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