Adjustment Disorder Symptoms and Their Effects

Adjustment disorder and the adjustment disorder symptoms can negatively impact all areas of someone’s life. Cedar Crest Hospital (2015) defines adjustment disorder as “a group of stress-related symptoms, including sadness, hopelessness, and feelings of being overwhelmed, that occur when a person is unable to properly cope or adjust to a major life stressor or event. These symptoms are disproportionate to the precipitating event." Indeed, according to The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or DSM-5 (American Psychological Association, 2013), the symptoms of adjustment disorder disrupt mentally healthy functioning and can lead to

• Decreased performance at work, school, and home
• Changes and difficulties in relationships
• The complication of existing mental and physical health conditions

Types of Adjustment Disorder Symptoms

The symptoms of adjustment disorder can be felt throughout the whole person; thoughts, feelings, behavior, cognitive processing, and the body can all hurt. In any area, the types of adjustment disorder symptoms can be classified as internalizing or externalizing.

Internalizing symptoms are those effects that are turned inward. They impact the person’s subjective internal world and may include:

• Feeling sad more often than not
• Decreased self-esteem
• Loneliness
• Hopelessness
• Loss of pleasure
• Sense of shame
• Anxiety such as worry, fear, nervousness
• Feeling on edge, keyed up
• Sense of being overwhelmed
• Suicidal ideation
• Self-harm
• Difficulty making decisions
• Trouble concentrating
• Decreased appetite
• Change in sleeping habits (too much or too little)

Externalizing symptoms of adjustment disorder are those that are reflected outward toward the world, either directed toward others or easily observable by others. They can include:

• Frequent crying
• Irritability or argumentativeness
• Rage
• Ignoring bills and other financial problems
• Poor performance at work or school
• Tardiness
• Absenteeism
• Vandalism or other legal problems
• Suicidal behavior

Adjustment disorder, like all mental health disorders, is quite personal and the symptoms differ for each individual. No one experiences all of the above symptoms. Some people mostly internalize; others mostly externalize.

Further, there are specific types of adjustment disorder, and each features symptoms specific to its classification. These include adjustment disorder with depressed mood, adjustment disorder with anxiety, adjustment disorder with mixed depressed mood and anxiety, adjustment disorder with disturbance of conduct, and unspecified adjustment disorder. The unspecified type includes a mix of the above symptoms that don’t fit neatly into one of the other types.

Adjustment Disorder Symptoms: Pattern and Purpose

No matter one’s symptoms, to receive a diagnosis of adjustment disorder, someone must have experienced (or be experiencing) an identifiable stressor. The stressor must occur first, followed by the symptoms of adjustment disorder that lead to significant disruption and impairment.

Adjustment disorder symptoms, whether internalizing, externalizing, or both, negatively impact the mind, body, emotions, and/or behaviors after or during a stressor. As miserable as they can be, they ultimately serve a positive purpose. They tell us that something is wrong so we can fix it and take charge of ourselves and our lives for mental health and wellbeing.

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