Imagine this: A 20-something man, let’s call him Tom, moves away from home to pursue his passion for theater in New York City. While initially excited about the adventure and all its potential, the day-to-day change is hard on Tom. The city itself is overwhelming – busy and loud – a massive departure from his comforting hometown. Finding consistent work is challenging, which adds a financial burden as Tom hustles to make rent. Although bustling with people, Tom finds himself lonely and misses the comfort, companionship, and security of home. Being constantly busy with work makes it hard for Tom to catch his breath and the loneliness only worsens. Tom loses motivation to attend social events and even getting out of bed becomes a challenge. He performs his backstage duties with lackluster.
Tom's symptoms suggest he may be experiencing an Adjustment Disorder, as the stress of his move has caused clinically significant emotional distress.
Can you relate to Tom's struggle in any way? Change and uncertainty can be challenging for even the most adaptable people among us. Whether the change is going away to college, getting a divorce, losing a job, breaking up with a significant other, or dealing with a combination of inevitable stressors, it can leave us feeling overwhelmed, isolated, inadequate, and disappointed. (Note: not always! Some change is incredibly positive, but this article is focused on the negative aspects of change and uncertainty.)
Adjustment disorder: According to the DSM
The Diagnostic and Statistical Manual of Mental Disorders (DSM) defines adjustment disorder as “the development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s).” The primary symptom is marked distress that is greater than one would typically expect based on the intensity of the stressor. In addition, the symptoms must negatively impact one's social, occupational, or other areas of functioning.
Adjustment disorder can look different from person to person, with symptoms typically falling into the categories of depressed mood, anxiety, or behavioral disturbances. Mental health professionals may specify a subtype based on how symptoms are exhibited by the individual. Those with the depressive subtype may experience low mood, tearfulness, hopelessness, or suicidal ideation. The anxious subtype is characterized by nervousness, worry, jitteriness, or separation anxiety from a person or place of comfort. Children may exhibit conduct disturbances, such as breaking school rules after their parents' divorce. In adults, it may result in outbursts of anger, violent behavior, or substance misuse. It is important to note that not everyone fits neatly into a subtype, as people's reactions to stress are unique, and symptoms can vary in type and severity.
Causes of an adjustment disorder
Adjustment disorder can develop in response to a single event, such as a natural disaster, concurrent events, such as a break-up while starting a new job, or chronic stress, like ongoing parental conflict at home. However, not everyone who experiences a significant change will develop adjustment disorder. Factors that may affect a person's ability to cope with stress include their economic status, access to social support, and availability of occupational and recreational activities. Additionally, people may be more vulnerable based on the amount of stress experienced during childhood and the degree to which they are experiencing anxiety at the time of the event. If you are already overwhelmed with daily stress, a significant event may tip the scales.
But hope is not lost yet! These feelings are often temporary and in the meantime, there are multiple ways to both treat and prevent the emergence of adjustment disorder.
Before, during, and after: 6 tips for taking care of yourself!
Too often in the face of stress, our instinct is to work harder, power through, and get more done. While it is important to manage responsibilities, overwhelming stress can leave you feeling worn down and vulnerable. To build resilience and increase your tolerance for life’s challenges, take the time (even if it feels like you have none) to engage in relaxing and enjoyable activities. Here are some things to try:
- Do something you enjoy
Give yourself a break from worrying and prioritize making time for an activity you love.
- Commit to a healthy lifestyle
Incorporate physical activity, eat well-balanced meals, and get enough sleep.
- Avoid drugs and alcohol
These are unhealthy coping methods that may feel good in the moment but will only worsen the problem in the long run.
- Use coping skills
Find what works for you! Whether it's listening to music, meditating, or journaling, if it provides you with a sense of calm, it's worth doing.
- Turn to others
Reach out to people in your life for support. You can share your concerns or simply find reassurance in their presence. Spending time with caring, healthy individuals can make you feel less alone and improve your overall well-being.
- Tackle problems head-on
Procrastination happens to us all. Try to complete (or at least start) the stressful task you've been avoiding early in the day. Your future self will thank you!
When you need a little extra help…
Reach out to a mental health practitioner. Adjustment disorder can be debilitating, but with the support of a therapist, you can process your feelings, learn new coping skills, and better manage stress. Treatment options vary depending on the life stressor and subsequent symptoms; a mental health counselor can tailor therapy to fit your needs. If you’ve recently experienced a significant life change or are anticipating one, having an experienced clinician to help you through the transition can make all the difference! Need help to find the right-fit therapist? We’re here to help.
Life is bound to throw curveballs your way, and sometimes it can feel like too much to handle. There’s no shame or weakness in that. It just means it’s time to take intentional steps toward improving your well-being. Prioritize caring for yourself and reach out for help getting you through this chapter and onto the next.