Adjustment Disorder With Anxiety In Adults: How To Cope

Adjustment disorders are a category of diagnosable mental health conditions, and “adjustment disorder with anxiety” is one of the six types in this category. Those living with adjustment disorder with anxiety often have symptoms of nervousness and overwhelm in response to seemingly normal, daily tasks, and they may also experience physical symptoms associated with anxiety. Here, we’ll take a closer look at this type of adjustment disorder and then discuss treatment methods.

Adjustment disorders are usually defined as severe and often irrational reactions to stressful events or changes in a person’s life—either an isolated, stressful event or multiple events over a short time. Usually, adjustment disorders affect children and adolescents, resulting in home and school symptoms that may be addressed by a child psychiatrist or therapist or in family therapy—but it is possible for them to affect adults as well. 

Six categories of adjustment disorder: Symptoms and treatment approaches

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, categorizes six distinct forms of adjustment disorder:

• Adjustment disorder with depressed mood
• Adjustment disorder with anxiety
• Adjustment disorder with mixed anxiety and depressed mood
• Adjustment disorder with disturbance of conduct
• Adjustment disorder with mixed disturbance of emotions and conduct
• Adjustment disorder unspecified

This type of mental health disorder often results in an inability to function in the same manner as one could before the life stressor that triggered the condition. While symptoms of adjustment disorder may be difficult to live with, they’re usually considered treatable. With the help of a licensed therapist who can make an accurate diagnosis, if applicable, you can develop coping strategies that may make it much easier to manage symptoms in daily life.

What causes adjustment disorders?

Adjustment disorders are typically caused by "life stressors": permanent or temporary changes or events that induce emotional hardship. A stressful event may be related to finances, the death of a loved one, significant problems related to work, medical hardships, marital problems or relationship problems, or other major life changes or challenges. In those who are younger, school or family issues can be common risk factors for adjustment disorders.

Identifying individual life stressors can be important in analyzing why a person may come to experience an adjustment disorder and how external conditions may impact their coping abilities. For example, those with economic stability and a support system may be less likely to be diagnosed with adjustment disorders.

Diagnosing adjustment disorder and understanding symptoms

Common symptoms of adjustment disorders: anxiety and depressed mood

Common symptoms of adjustment disorders in general can include emotional signs and behavioral reactions like impulsive choices and reckless behavior, social withdrawal, tension and nervousness, and twitching or shaking. We’ll discuss symptoms of an adjustment disorder with anxiety in more detail in the next section.

Diagnosing an adjustment disorder can sometimes be difficult because the individual may not always recognize the original stressor. That is why it can be crucial to discuss the situation with a professional who can aid in identifying the possible cause and whether the symptoms may be clinically significant. Without knowing what precipitated the disorder, it can be more difficult to alleviate and prevent symptoms in the future. 

Adjustment disorders vs. post-traumatic stress disorder

In the diagnostic process, it can also be important to distinguish between an adjustment disorder and post-traumatic stress disorder (PTSD). Both involve a stressful event leading to emotional and behavioral symptoms. However, with PTSD, the stressful past experiences were typically a life-threatening situation or an otherwise severely traumatic event—such as sexual assault, military combat, or a natural disaster. With adjustment disorder, it can be almost any type of life change.

What adjustment disorder with anxiety in adults can look like

As mentioned above, an adjustment disorder can manifest with anxiety or both anxiety and depressed mood. Adjustment disorder symptoms for those with the anxious type are usually associated with nervousness and worry, which can lead to feeling overwhelmed by simple tasks, trouble remembering things, and difficulty concentrating. 

Other emotional and behavioral symptoms

If a depressed mood is also a feature, the individual may experience persistent low mood or sadness, hopelessness, and changes in sleep or appetite as well. An adjustment disorder with anxiety and depression may sometimes be referred to as "situational depression.” Adults with anxiety may also experience adjustment disorder with disturbance of emotions and conduct, though such a presentation is more common in children. In this case, they may exhibit feelings of anxiousness alongside a disregard for societal norms or the rights of others.

Other symptoms of an adjustment disorder with anxiety can include agitation, social withdrawal, stress, and trouble functioning at the same level as before the event. In addition to these emotional symptoms, a person may also experience physical symptoms of anxiety, such as trembling, twitching, palpitations, and pain of the stomach, head, or chest. In some cases, suicidal thoughts may also be a symptom.

Potential effects of untreated adjustment disorder with anxiety

When left untreated, adjustment disorders with anxiety may create behavioral issues and impact a person's ability to function. Adjustment disorders may also lead to substance misuse. If unresolved, adjustment disorder can contribute to other psychiatric disorders, such as major depressive disorder.

Due to their potential physical and psychological effects (fatigue, anxiety, physical pain, etc.), adjustment disorders can also lead to challenges at home, school, and work. If left untreated, all of these have the potential to lead to other issues that become "life stressors," potentially perpetuating a cycle of anxiety and causing the individual to continue feeling overwhelmed.

How to cope with adjustment disorder: Common treatment methods

Adjustment disorder can often be treated effectively within a short time frame. The exact type of treatment that may work best for a given individual depends on their age, life circumstances, and any co-occurring mental health conditions. It’s recommended that you meet with a mental health professional for support if you’re experiencing symptoms so you can get treatment advice for your unique situation. The following are treatment methods a provider may recommend. 

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a type of talk therapy. The general goal is to help an individual learn to recognize and then shift any patterns of distorted or negative thoughts that may be contributing to distress. For those with an adjustment disorder, CBT may help them break the cycle of being so deeply affected by certain life stressors. It can also be an opportunity for them to develop healthy coping skills to use in daily life.

If you’re experiencing symptoms of adjustment disorder or another condition or are simply looking for support in managing stress, meeting with a mental health professional is generally recommended. Those who have trouble locating a provider in their area or would feel more comfortable engaging in counseling from home might consider exploring online therapy. Research suggests that online CBT may be an effective method for treating psychiatric disorders, such as adjustment disorder with anxiety in adults, as studies indicate that online therapy can generally be as effective as traditional in-office therapy.

Support groups for adjustment disorder and mental health

Support groups can also be useful for an individual who is experiencing a specific type of life stressor, such as divorce or loss. These groups can be a helpful source of peer support from those who can understand what the individual is going through and can compare notes on coping strategies for adjustment disorders. Simply being able to talk with others who understand can offer significant relief. Similarly, you could explore group therapy, which consists of peer discussions led by a licensed therapist. You may be able to find virtual or in-person support or therapy groups if you’re interested in this method.

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Medication for adjustment disorder with anxiety in adults

Medication is sometimes used for the treatment of adjustment disorders—typically in combination with therapy. It’s crucial to speak to a qualified doctor or psychiatrist before starting, stopping, or changing any medication.

Lifestyle changes

Making certain lifestyle changes may also help reduce symptoms of an adjustment disorder or even prevent them from occurring after one experiences a life stressor. These changes usually aim to limit the stressor’s impact so that you can overcome adversity in your daily life. 

For example, many find it important to have social support they can lean on in the form of family, friends, or community members. Setting goals and celebrating achievements might also help you stay on track with healthy stress-management habits. Engaging in self-compassion—particularly when you're experiencing difficulties—could make a significant difference as well. Finally, typical healthy lifestyle habits can be helpful too—such as eating nutritious foods, staying hydrated, exercising regularly, and having a healthy sleep routine.