Adjustment Disorder and the Anxiety of Facing Change
Are you facing change that's increasing feelings of stress and anxiety? Anxiety can be related to adjustment disorder. We humans often dislike change; sometimes we even fear change. When change creates such stress that it interferes in the ability to fully function in life (work, school, interpersonal relationships, etc.), a diagnosis of adjustment disorder by a primary care physician, therapist, or other health care provider is sometimes in order. If you're facing change and experiencing difficulties, know that you're not alone. Anxiety can be related to adjustment disorder, and treating both anxiety and adjustment disorder is possible.
Do I Have an Adjustment Disorder?
Life changes can cause stress and anxiety or increase already existing anxiety. According to the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (the DSM-5), adjustment disorder is "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 changes cause significant distress, and they interfere with one's ability to work, play, socialize, interact, and in general live life.
While adjustment disorder is classified as a trauma- and stress-related disorder rather than an anxiety disorder, facing change and experiencing adjustment disorder can exacerbate anxiety. Whether change is positive (such as starting school, moving, or having a baby) or negative (such as a move that you don't want, being fired from a job, or going through a divorce), it disrupts life as we know it. Change brings upheaval, and upheaval can increase anxiety.
Adjustment Disorder Causes
When we're going through change, it's normal to experience stress and anxiety. After all, we have new routines, new norms, new rhythms, and a lot of unknowns. When adapting to the new and dealing with the unknown feels impossible, it's not uncommon for people to become stuck, mired in things like anxiety and even depression. It's the inability to adjust that leads to a diagnosis of adjustment disorder.
When we're facing change, anxiety can be closely related to adjustment disorder. The racing thoughts, fear, worry, agitation, avoidance, physical symptoms, and emotional disturbances of anxiety can be made worse by adjustment disorder, or they can be newly caused by adjustment disorder.
Whether anxiety is intensified by change and adjustment disorder, or whether it is caused for the first time by change and adjustment disorder, it doesn't have to last. Both anxiety and adjustment disorder can be treated and managed even when you're facing change.
Treating Anxiety Related to Adjustment Disorder
When we experience a positive change, we don't want anxiety to hang around interfering in the our new happiness. When we experience a negative change, we want to get through it and move on rather than letting anxiety and adjustment disorder keep us stuck where we don't want to be. To be sure, overcoming change-related anxiety isn't as simple as "just getting over it." Happily, though, we don't have to surrender. While we can't always control the changes that come our way in life, we can control our actions, reactions, and forward movement.
The following list of ideas contains a few ideas for overcoming anxiety related to change. It's very helpful to work with a professional therapist as you go through the process of adjusting to change and decreasing anxiety, but these thoughts might be helpful or even lead to new ideas of your own.
- Define what it will be like when you're unstuck and less anxious. Knowing that you don't want anxiety to hold you back won't quite get you to where you want to be. Know specifically what you want, keep your thoughts on that rather than on your anxiety and adjustment difficulties. A positive, specific goal or vision is easier to work toward than merely not wanting anxiety.
- Create small action plans to get you to where you want to be. What little things can you do every day, or every hour in the day, to overcome anxiety and work toward your vision? Small, regular steps make big progress.
- Identify your symptoms and rank them from most bothersome to least bothersome. This will let you tackle your symptoms one by one. Determine what makes you feel better, and commit to doing these things regularly.
- Create new routines. Part of anxiety and adjustment disorder comes from a disruption in routine. Take charge of making new routines in your life at home, school, work, etc. As you fall into predictable routines, the newness won't feel foreign and uncomfortable anymore, and anxiety related to adjustment disorder will decrease.
Facing change can be difficult. Thankfully, there are numerous ways to decrease anxiety related to adjustment disorder. How have you dealt with change?
Peterson, T. (2015, July 9). Adjustment Disorder and the Anxiety of Facing Change, HealthyPlace. Retrieved on 2021, June 18 from https://www.healthyplace.com/blogs/anxiety-schmanxiety/2015/07/facing-change-anxiety-can-be-related-to-adjustment-disorder
Author: Tanya J. Peterson, MS, NCC, DAIS
This gives me great reassurance. My anxiety has creeped back up on me the past few weeks. I decided to quit my full time job and work part time - to go back to college. I get so anxious now going to work and am questioning if college is for me. Should I just go back to my full time role where I was comfortable ? I don't really have a routine anymore and it scares me a bit. I don't know if I even want to do the course anymore so many taughts going around my head it's wearing me out!
This article sure helped a lot. I have a new girlfriend. I have not had a real serious girlfriend in 10+ years (if ever). I am 30 and went from no girlfriend to spending 6 to 7 days a week with her. She is great, beautiful, sweet, has the same beliefs as me, I love her family etc. I has recently had moderate to severe anxiety. , after just about 3 months into the relationship. I went to a therapist and got diagnosed with adjustment disorder with anxiety. I also quit drinking and smoking cannibus. I did not quit FOR her, but because I want to make sure that I am the best man I can be for sure, because she is such an great person and I want to deserve her. Could this new, good, relationship be cause me this adjustment/anxiety. Sometimes my thoughts resort to thinking I feel this way because I should not be with her, however when I calm my anxiety, I realize she is amazing and amazing for me! I don't know what to do or think. Is there something you suggest to help me get over this before I let it ruin my otherwise awesome relationship?
Hi Love Sick RJ,
New relationships can definitely be a source of adjustment disorder with anxiety. Even positive change can be anxiety-provoking. Are you still seeing the therapist? If not, returning for a few sessions could help you develop ways to overcome your anxiety. Also, you might try practicing mindfulness. Mindfulness is the practice of paying attention to the moment you're in. When you catch your thoughts wandering to relationship anxiety, gently re-focus them and think about what's going on in the moment. Use sight, sound, smell, touch to ground yourself in what is going on in your life right now rather than with the worries. It takes practice and repetition, but people often find that they get into the habit of automatically doing this so that when anxiety pops up like it does, they can slip away from it rather than sticking to it.
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I'm a bit scared about the effect of moving abroad will have on me :( I am afraid about this adjustment disorder, because I do suffer from mental illness. Try to find more about treatment for adjustment disorder with disturbance of conduct at http://adjustmentdisorders.org/treatment/disturbance-of-conduct. What do you thin about this treatment plan?
It's great that you are being proactive and looking into ways to minimize the effect your big move will have on you. Having a treatment plan is an excellent idea. Any plan online is a general sample and can be modified to suit each person's unique needs. Treatment plans are very individualized, so what is a great plan for one person might be ineffective for someone else. Seeking input from a doctor or therapist will help you help yourself in the best way possible. Good luck to you in your upcoming move. Looking for positives and ways to be active in your new home will help adjustment a great deal.
Thank you for this article! I think I have found a name for what I experience whenever big life changes happen for me. My anxiety manifests itself through fear of contracting a disease. The first time it happened was after I decided to move permanently to Europe. Within a 1/2 hour I was suddenly terrified that I had several diseases and spent 5 months getting tests done over and over, when I would have confirmation that I did not have one disease my brain would automatically look for another potential disease or at another way I could have contracted a disease. This went on until my Dr told me that it was simply the fear of the unknown and that I just needed to take time for the change to happen and everything would fall in place. It took a good year to get over the fears of illness. 7 years later I am experiencing the same thing, we are moving from a big city to a small village, and I find myself once again struggling with the fear of illness and the fear of passing illnesses on to my loved ones. With this change in my life being nonetheless a positive one I do wonder how common it it to have the apprehension of change manifest itself through a sort of hypochondriasis. Any thoughts on this would be just super! Thanks for your time. Francie
I'm glad that this article was helpful! So often, knowing that there's a word (or words) to describe what's going on makes a big difference. For me, anyway, part of the reason for this is the comfort that comes from realizing that there is something official to what I'm experiencing. Which means I'm not "crazy" and not the only one. The experience of having anxiety and adjustment challenges show up in the body as symptoms of disease is actually pretty common. Studies show that anxiety disorders (and many other disorders, too, including adjustment disorder) are responsible for a large number of doctor and emergency room visits every year. While I've seen studies that apply the the United States, this is a universal human experience. Anxiety, adjustment disorder, the discomfort with change (even positive change, like you said) are common, and they show up differently for different individuals. Anxiety can create physical symptoms in every system of the body, and it really does mimic disease. It's insightful that you've recognized your own pattern (not always an easy task). Knowing this can help you have productive conversations with your doctor. It is good to rule out any medical conditions that might be happening, and when you visit your doctor for this reason, it's okay to tell him/her about your personal experience with anxiety, change, and adjustment. It can help him/her know what to do to actually help rather than to just order tests and move on. :) Good luck with your move and adjusting to village life! Be patient with yourself and give yourself time to settle in. Even positive change can take quite a bit of time to get used to.
This is me to a tea. I just went through a bad time and, shortly, will be turning 65years old. All that goes with being 65terrifirs me. I broke out in hives and now have to see the doctor again for help.
Ugh. I'm sorry about your hives. When I'm particularly anxious or stressed, I break out in hives, too. :) Next, happy early birthday! 65 is a big milestone as it represents a new stage of human development. I wonder how you'd feel/think if you wrote down (or drew) everything that comes to your mind when you think about all that goes with being 65. You might find that the picture is incomplete, and if so, you could add positive things that come with being 65 (thinks either in your life already or that you can add to your life). Sometimes getting thoughts and images out of our head and onto paper in either words or pictures can help shift perspective.
i have been reading this and find I have become terribly anxious and it is driving me nuts as well as my partner. I am always worried and focused on our relationship. I constantly think and worry about everything and make a mountain out of a mole hill. I am scared I am going to fall apart. Please help.
Something that is so common to any type of anxiety is the feeling that you're going to fall apart or lose it or go crazy. Anxiety makes thoughts race so quickly plus there are biological things happening in the brain (if you are interested, this article talks a bit about the physical/biological nature of anxiety and how it makes our brain feel like a pinball machine: http://www.healthyplace.com/blogs/anxiety-schmanxiety/2014/02/anxiety-its-in-your-head-yo…). Creating a "toolbox" of ideas and strategies to use to reduce your anxiety and calm your thoughts when they race goes a long way toward helping keep those mole hills the right size. Anxiety-Schmanxiety is dedicated to providing information about anxiety, including treating it. Reader comments can be very helpful, too. There are also forums on the HealthyPlace website to learn about anxiety and share ideas with others. You already have awareness and are reading and reaching out. You're well on your way to beating this!
Makes it sound so easy.
I suppose it's deceptively easy. :) Adjusting to change and overcoming the anxiety that can come with it is a process that doesn't just happen overnight. Wouldn't that be great! But it absolutely can happen, and even though it doesn't always feel like it, we do have the power and ability to make it happen.
Very helpful article.... I was forced to Move to another state 2 1/2
yrs since my husband passed. Hv had a lot of turmoil in last few yrs & no one to help me really
"Turmoil" sounds like an apt description of the disruption in your life. Grieving for your husband while also adjusting to a move like that would be difficult. I'm glad that you found this article helpful. Healing is very possible. Be patient and kind to yourself as you go through the process.
Tanya this may test your knowledge, but I'm sure you've dealt with worse! I'm 31 years old and suffer from occasional anxiety, the funny thing is it mainly comes on strong when my wife goes away for over 4 days! We have no kids, but have 2 dogs and a couple of months ago was my 1st incidence - my wife went camping for about a week with both our dogs and slowly but surely I worked myself into a crazy state, so crazy I had pins and needles everywhere, feet legs body arms hands and face, my wife is now going back home to Ireland for a week and today I felt very anxious just knowing that I will be encountering a similar scenario, positive side the dogs will be staying so should help slightly with loneliness - this is a recent issue that I seem to have developed - any ideas or pointers to get over this? Thanks
Would it be helpful to know that what you're experiencing isn't obscure, unheard of, strange, etc.? Although I'd never try to make any kind of diagnosis based on a paragraph, even one as clear and descriptive as yours, what you describe sounds like a type of anxiety known as adult separation anxiety/adult separation anxiety disorder. I actually wrote an article about it last summer. Here is a link to it if you're interested in reading about ASAD: http://www.healthyplace.com/blogs/anxiety-schmanxiety/2014/07/separation-anxiety-its-not-….
Like all types of anxiety, this can be overcome. If you have strategies for dealing with your occasional anxiety that have worked well for you, keep using those. With ASAD, it's important to develop things to do and ways to be that help you feel calm. When you feel panic begin to rise (that pins-and-needles sensation is part of a panic attack, which can be mild or severe), do things such as deep breathing, engaging your senses (squishing clay or play-doh, paying attention to the taste and feel of gum, etc.). That will help return your mind to the moment. Also, perhaps you and your wife might come up with a simple, regular routine for when she's gone such as phone calls or texts at a regular time, drinking coffee or tea "together" at the same time (a bit tricky with the time zone difference, but it might be possible.) And enjoy spending time with your dogs!
Wow! This article is spot on and I see myself through it. I lost my job more than a year ago and am still having difficulty adjusting. My age and a few physical issues are hindering the possibility of a new job and that has added to my problems adjusting. Thank you for the ideas. It appears I need to find a new therapist and start moving again. It has been very hard but now I may have a clue as to why I sit here in my chair, half afraid to venture out and TRY again. Thank you so much for this piece!
Thank you so much for your comment/feedback. I'm very glad it was helpful. It's amazing how powerful change and anxiety are -- powerful enough to pin us down. Happily, they're not powerful enough to keep us down forever. It takes strength to get moving again. Hooray for you and your strength!