Adjustment disorder: Symptoms, causes, and treatment

Reviewed by Robert Bogenberger, PhD

Written by

therapist.com team

Last updated: 04/30/2026

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What is adjustment disorder?

Adjustment disorder is a stress or trauma response and mental health condition that happens after a stressful life event.¹ You may feel as if the stressor dominates your thoughts, making it difficult to maintain your daily routine, work performance, or personal relationships.

The disorder is common in medical and mental health treatment settings, but in the general population only an estimated 1% to 2% of people will experience it.

Adjustment disorder symptoms

Symptoms of adjustment disorder begin within three months of the distressing event (or series of events). Importantly, adjustment disorder involves responding to a stressor in a way that is either much more intense than expected or that causes difficulty in functioning.

Common symptoms include:²

• Feeling intensely sad, anxious, or on edge
• Crying more than usual
• Trouble sleeping or concentrating
• Constant worry or rumination about the event and its effects
• Irritability
• Pulling away from others
• Physical symptoms like a racing heart or trembling
• Acting impulsively or “out of character”
• Problems at work, school, or home

Sometimes people with adjustment disorder have thoughts of suicide or self-harm.³ If you or someone you know is in crisis, call or text the free, confidential 988 Suicide & Crisis Lifeline at 988 anytime, 24/7. You can also text HOME to 741741 to connect with a crisis counselor.

Remember that there’s no benchmark you need to meet to justify involving a mental health professional in your care. Browse our directory to connect with a licensed therapist near you.

Types of adjustment disorders

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) recognizes “specifiers” or subtypes of adjustment disorder based on a person’s main pattern of symptoms.⁴ While some researchers question whether these subtypes are truly distinct, the DSM retains them.⁵

Adjustment disorder with depressed mood: Sadness, low energy, crying, and loss of interest are most noticeable. Thoughts may focus on loss or what has changed.

Adjustment disorder with anxiety: Anxiety or nervousness is a main feature. People often worry, feel tense or jittery, and have physical anxiety symptoms like a racing heart.

Adjustment disorder with disturbance of conduct: Behavior changes stand out, whether that’s acting out, rule-breaking, or risk-taking.

Mixed types and unspecified: Many people have both anxiety and depressed mood, or emotional symptoms plus behavior changes. If a pattern of symptoms doesn’t fit neatly into one category, “unspecified” may be used.

What causes adjustment disorder?

Any major life stress or trauma could lead to adjustment disorder. It largely depends on the individual, but common stressors include:⁶

• Divorce or relationship problems
• Illness (your own or a loved one’s)
• Financial worries or job loss
• Moving or major life changes
• Challenges at school
• Family conflict
• Environmental or traumatic events

Large-scale stressors can also be a source of trauma. For example, early in the COVID-19 pandemic a study based in Poland explored the results of the severe stress the event was causing. About 14% of the study participants met criteria for adjustment disorder after accounting for other conditions.⁷

How adjustment disorder affects daily life

Adjustment disorder can make it hard to:⁸

• Focus at work or school
• Sleep well
• Keep up with routines
• Stay connected with people
• Make healthy choices

Without proper treatment, adjustment disorder can sometimes lead to serious, long-term mental health issues. It’s also associated with an increased risk of suicidal thoughts and self-harm at levels similar to those seen in people with depressive disorders.⁹

How adjustment disorder is diagnosed

Only a qualified medical or mental health professional can make a diagnosis and help you develop a plan for coping. Clinicians diagnose adjustment disorder largely by exploring your personal history. They’ll assess when symptoms began, how much they impair your daily life, and whether they’re better explained by a different condition or concern.

If you have specific concerns about your health, speak to your health care provider or browse our directory to find a licensed mental health professional near you.

Adjustment disorder treatment options

Many people benefit from brief, practical support. Your provider will tailor care to your symptoms, life events, and preferences.

Treatments used to treat adjustment disorder include:

• Cognitive behavioral therapy (CBT): This form of therapy helps you notice and change unhelpful thoughts and build healthy behaviors. Studies show both in-person CBT and internet-based CBT (iCBT) could help reduce adjustment disorder symptoms.¹¹
• Guided self-help and bibliotherapy. One small study showed short, structured programs in which participants worked through self-help manuals helped with worry and rumination.¹²
• Brief skills-training programs. The program Skills for Life Adjustment and Resilience (SOLAR) shows early promise and is currently being tested and expanded in several countries to help with adjustment difficulties at a subclinical level.¹³

Medications can be considered as an added measure for sleep issues, severe anxiety, or depressed mood. However, they would typically only be used alongside therapy.¹⁴

Coping strategies

These simple steps can help you feel more in control while you get care:

• Name the sources of your struggles and set small, specific goals to address what you can change.
• Schedule your day. Maintain a regular sleep schedule, leave yourself time for complete and healthy meals, incorporate movement, and make sure to get enough social contact.
• Limit rumination time. Try a designated “worry window” of 15 minutes daily. When your anxieties surface outside of that window, refuse to engage with them.
• Practice skills like slow breathing, grounding, or brief mindfulness.
• Reduce triggers. This might includelimiting screen time, setting practical steps for finances, or changes to work or care plans.
• Ask for support. Share with trusted people and consider working with a therapist for CBT or brief counseling.

If your stressor is ongoing (for example, caregiving or job issues), plan regular check-ins with your clinician to adjust strategies.

When to seek more help

Many people improve within a few months, especially when the stressor eases and support is in place. But in some cases, symptoms can last or get worse, and a subset of people go on to develop a more severe disorder like major depression, generalized anxiety disorder, or posttraumatic stress disorder (PTSD).¹⁵

Reach out for support immediately if:

• You have thoughts of self-harm or suicide
• You’re not able to work or care for yourself
• Symptoms are getting worse after a few weeks
• The stressor continues and coping feels difficult

Visit our therapist directory to connect with licensed mental health professionals online or in your area.