Adjustment Disorder

Adjustment Disorder is a category in the DSM (Diagnostic and Statistical Manual of Mental Disorders)  described 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).  Most stressors cause identifiable symptoms, but when the severity, intensity, and duration of the symptoms start to significantly interfere with relationships, work, physical health, and take the joy out of living, there is cause for concern.

The DSM even identifies some of the stressors that can cause lingering problems to develop:  termination of  a romantic relationship, unfulfilling sexual relationships,  business difficulties, marital problems, persistent painful illness, living in a crime-ridden neighborhood, loss of a loved one, changes within a family, unemployment, retirement . . . .  Most of us are having to adjust on a fairly regular basis either to personal stressors or stressors to those we know.

Building resilience to stress makes more sense than trying to avoid it.  Resilience starts with taking care of our physical needs, even during times of pressure.  Finding time to eat right, exercise, and sleep are essential building blocks in becoming stronger.  Finding ways to relax helps us to bend rather than to break and is best cultivated before a crisis comes.  Putting together our personal “board of directors”—people from bankers to doctors to babysitters—can be a strong resource to support us with good advice when times of stress require us to make difficult decisions.  Therapy offers an intervention that helps in reframing stress in terms of opportunities for new growth and new insight.

Although there is no exact time limit for working through adjustment to a stressor, if there is no improvement in about 6 months, it is possible that the stress has indeed become a disorder and requires professional help. The indicator of healthy progress is not “snapping out of it” but being able to go forward with the activities of daily life, however slowly, and once again find meaning.