Can adjustment disorder turn into PTSD?

In this guide, we will answer the question ” Can adjustment disorder turn into PTSD? “

What is adjustment disorder?

Adjustment disorder is a very common short-term disorder that happens when a person has difficulty in dealing with, or adjusting to, a specific source of stress, such as a sudden life change, loss of a valuable person, or an expected event.

Adjustment disorder is very common. In fact, experiencing a traumatic event is much more common than most people realize. 

Large-scale studies have found that most people will experience some kind of traumatic event at some point in their lives. 

This is not unexpected as everyone can experience some kind of stressful event at some point in their life.

When people experience an adjustment disorder they usually have some of the symptoms of clinical depression. 

For example, they start crying without a reason, feel hopeless and lose their interest in their works or their ongoing activities.

Informally, this disorder frequently named as  “situational depression.”

However, major depression, is different from the adjustment disorder  as it doesn’t contain the physical and emotional symptoms of clinical depression like  changes in sleep, appetite and energy or high levels of difficulty like suicidal feeling or behavior.

Symptoms of adjustment disorder

Adjustment disorder which is a mental health condition defines complications adjusting or reacting to a stressor.

It comprises of the subsequent symptoms:

  1. The development of emotional such as distress or behavioral such as avoidance symptoms due to a stressful life event. The symptoms starts appearing in three months after the stressful event starts.
  2. These symptoms may cause greater distress than would be expected in response to a stressful life event.  Symptoms intervene with pieces of a person’s life like work, school, or social.
  3. The symptoms are not because of another disorder, such as major depression or an anxiety disorder.
  4. The symptoms are not linked to mourning about the loss of a loved one.
  5. When the stressor has come to an end, the symptoms fade away in six months.

If a person has an adjustment disorder, they may experience depressed and/or anxious mood.

They may also experience problems in behaving appropriately.

For example, a person with adjustment disorder may increase their alcohol consumption as a way of trying to cope with the stressor.

Causes of adjustment disorder

The precise cause of adjustment disorder is not known because the cause is possibly complicated and involves genetics, life experiences, personality and changes in the brain  like other mental disorders.

Following stress types may trigger an adjustment disorder that can change person to person:

  • Ending of a relationship or marriage
  • Losing or changing job
  • Death of a loved one
  • Developing a serious illness relation to you and someone important for you
  • Being a victim of a crime
  • Having an accident
  • A major life change such as marriage, having a baby or retirement
  • Experiencing a disaster, such as a fire, flood, or hurricane

For example, the loss of a someone you love much may cause other significant life changes and adjustment.

An elderly widow may not be able to live alone in the house where she lived in for a long time, and therefore she may move to an assisted living institution. 

Common symptoms include:

  • Anxiety
  • Hopelessness
  • Worried or depressed thoughts
  • Mood instability 
  • Difficulty concentrating
  • Loss of pleasure
  • Changes in eating habits
  • Fatigue or insomnia
  • Frequent crying
  • Impulsive behavior
  • Social isolation
  • Decreased school or work performance

How to Better Cope

Although stressful events and adjustment disorder are widespread, you can do many things to overcome these events and decrease your possibilities of developing adjustment disorder.

For instance, looking for social support and problem-solving healthy ways of getting over a stressful life event. 

Diagnosing adjustment disorder

A diagnosis of adjustment disorder usually requires a full psychological evaluation by a psychiatrist or other mental health professional.

This evaluation will typically take into account past experiences, behaviors, emotions and sources of stress, among other factors.

When diagnosing children or adolescents, parents may also be present during the evaluation.

The key diagnostic criteria for adjustment disorder are:

The symptoms must have begun to appear within three months of the stressor occurring

The condition must be characterized by stress that is in excess of what would be considered normal under the circumstances and which leads to significant impairment of a person’s personal life, social functioning, their work or school performance and/or attendance

The symptoms must be distinct from similar disorders, such as post-traumatic stress disorder (PTSD)

Treating adjustment disorder

The chosen treatment method for adjustment disorder will usually depend on a variety of factors, including age, severity of symptoms and the subtype being experienced.

Individual psychotherapy

Individual psychotherapy may take a cognitive-behavioral therapy (CBT) approach, particularly in the U.K., buy in the U.S., other kinds of talk therapy may often be recommended, too.

Because the condition is defined as short-term, this will typically be solution-focussed, short course of psychotherapy.

The treatment goal is to equip the affected person to understand how to overcome adjustment disorder by teaching them techniques for dealing more effectively with their particular problem and its effects on their life.

Family therapy

Family therapy will generally be recommended in cases of childhood or adolescent adjustment disorder.

It is designed to overcome conflicts in family life and improve communication skills among family members.

It may also be useful in teaching family members how to support the child/adolescent who is experiencing adjustment disorder.

Group therapy

In some cases, sharing challenge and coping techniques with a group of people also experiencing the condition can equip a person to understand how to overcome adjustment disorder in a practical sense and to apply this to their own life.

Group therapy can also help the person improve their communication skills and can be a useful source of support and encouragement.

Medication

Although supportive, solution-oriented psychotherapy is the first-line treatment for adjustment disorder, medications are sometimes additionally prescribed.

When medications are prescribed, they are used in order to treat specific symptoms of adjustment disorder ‒ for example, if a person is sleeping badly, is experiencing nerves or anxiety most of the time or is excessively depressed.

It is for this reason that medications are usually only prescribed in severe cases, are carefully evaluated by a person’s medical care team and are most likely an adjunct to rather than a replacement for talk therapy, which targets the condition’s root cause.

Medications which may be used in the treatment of adjustment disorder include:

Antidepressants. 

These will usually only be prescribed if depressive symptoms are still having a major impact on a person’s life three months after beginning non-medication-based treatment for adjustment disorder.

Benzodiazepines. 

These medications may help alleviate anxiety and problems sleeping in the short-term.

However, they are not recommended for long-term use due to their addictive potential and should only be prescribed and taken after careful evaluation by a doctor.

Good to know: 

There are some herbal remedies which are being investigated for their potential effects on adjustment disorder symptoms, especially those of anxiety and insomnia.

These particular herbal remedies include extracts of passiflora and valerian.

However, overall, these substances have not been sufficiently scientifically researched and evaluated for their safety and efficacy to be generally recommended.

Always consult a doctor before using any type of herbal preparation, as they may not be safe for particular people or in combination with certain medications.

Difference between Adjustment Disorder and PTSD

A single traumatic event can affect lasting changes on an individual emotionally, psychologically, physically and behaviorally.

It’s predicted that 70% of adults in the United States will experience at least one traumatic event in their lifetime. 

While both disorders are triggered by an external traumatic or stress-related event, they differ in onset, symptoms and duration.

The ability to distinguish between the two can facilitate faster diagnosis and more effective treatment.

Depending on the traumatic event and symptoms, a person could go on to develop a trauma or stress-related disorder such as an adjustment disorder or post-traumatic stress disorder (PTSD).

On the other hand, the diagnosis for children and adults who suffer an unpleasant life experience or stressor might not meet the criteria for PTSD.

Stressful events such as these can be very difficult to handle and can have a major effect on a person’s life.

However, according to the Diagnostic and Statistical Manual of Mental Disorders – 4th Edition (DSM-IV), adjustment disorder may not lead to the development of posttraumatic stress disorder (PTSD).

In its place, it can cause a kind of disorder called adjustment disorder. 

One of the main differences between adjustment disorders and PTSD is that an adjustment disorder onset involves a stressful event or change in environment while PTSD is triggered by an overwhelmingly traumatic event.In comparison, PTSD occurs after exposure to a traumatic event like military combat or sexual assault.

The trauma can be first-hand, perceived or has happened to a close family member.

While the symptoms of posttraumatic stress disorder (PTSD) may seem similar to those of other disorders, there are some significant and important differences.

For example, PTSD symptoms may seem similar to those of anxiety disorders, such as acute stress disorder, a phobia, or obsessive-compulsive disorder.

But in general, in anxiety disorders, there usually isn’t a specific triggering traumatic event for the anxious feelings or worry.

Or, in the case of something like phobias, it’s a trigger that most people don’t experience as anxiety-provoking.

General PTSD symptoms must last for more than one month and must interfere with relationships or work.

To be diagnosed with PTSD, a person must meet the following symptom criteria for at least one month:

  • One or more re-experiencing symptoms, such as flashbacks
  • One or more avoidance symptoms, such as avoiding places that are a reminder of the traumatic event
  • At least two reactivity and arousal symptoms, such as becoming easily startled
  • At least two mood and cognition symptoms, such as feelings of guilt or loss of interest in activities previously enjoyed

Helpful Resources

  1. Adjustment disorder: MedlinePlus Medical Encyclopedia
  2. Adjustment disorder: MedlinePlus Medical Encyclopedia
  3. Adjustment Disorder | Psychology Today
  4.  Adjustment Disorder: Current Diagnostic Status – NCBI

Conclusion

Adjustment disorder is a common psychiatric disorder but has received limited attention in research settings.

Many pitfalls in diagnostic criteria need to be addressed, though the concept has fair utility in the clinical setting.

In both psychiatric and general medical setting, the diagnosis of adjustment disorder is a useful clinical construct, especially when patients are faced with considerable physical and psychological stresses.

Further systematic research about this disorder may help in strengthening evidence base and enabling better clinical decisions.

Side Note: I have tried and tested various products and services to help with my anxiety and depression. See my top recommendations here, as well as a full list of all products and services our team has tested for various mental health conditions and general wellness.

References

  1. Very Well Mind
  2. Gulf bend
  3. WebMD
  4. The recovery village
  5. PsychCentral

Adjustment disorder FAQs

What happens if adjustment disorder lasts longer than six months?

The time frame of adjustment disorder is variable.

The condition usually develops some time after a stressful life event and gets better within six months of the stressor ending.

21 While this is the time frame referred to in most diagnostic manuals, others accept that some of the symptoms may persist longer, especially if the condition is caused by an ongoing stressor.

Therefore, it is important to note that a person may be affected by the condition for longer than the usual time frame if the causal stressor is chronic, i.e. has long-term consequences or is itself long-lasting, for example unemployment or a severe, long lasting medical condition.

22 Adjustment disorder which is longer-lasting than usual is sometimes referred to as chronic adjustment disorder.

Am I entitled to compensation if I need to take time off work due to adjustment disorder?

People who experience adjustment disorder and are in a paid position may be entitled to paid sick leave ‒ a kind of compensation ‒ if their condition is severe enough to warrant time off work for them to get better medically.

Is there a diagnostic test for adjustment disorder?

Although various diagnostic questionnaires have been developed and trialed as possible screening tools for detecting adjustment disorder, i.e. the Adjustment Disorder New Module 20 Questionnaire, the idea of using a diagnostic test is not universally-accepted as a necessary part of the diagnostic process.

Currently, the condition is usually diagnosed by considering the symptoms themselves, their timeline and the specific cause(s) of a person’s symptoms.

What we recommend for PTSD

Professional counselling

If you have PTSD, then ongoing professional counselling may be your ideal first point of call. Counselling will allow you to practice various habits that improve your overall quality of life.

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