Adjustment Disorder Vs. PTSD: What Are The Differences?

Medically reviewed by Nikki Ciletti, M.Ed, LPC
Updated October 11, 2024by BetterHelp Editorial Team

At first glance, post-traumatic stress disorder (PTSD) and adjustment disorder might seem a lot alike. They’re both mental illnesses that can result from stressful events, and they can cause similar symptoms, like changes in mood and motivation. However, there can also be a few key differences in their causes, types, and timelines that may be helpful to understand. For example, adjustment disorder typically develops in response to less severe stressors, and its timeline tends to be shorter overall. Both PTSD and adjustment disorder may be effectively treated with therapy and other interventions.

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Treating PTSD and adjustment disorder is possible

What is adjustment disorder?

When you notice significant emotional or behavioral symptoms due to a stressful event in your life, you might be experiencing adjustment disorder. Adjustment disorder can be seen as a negative response to major life stressors, such as those listed below:

  • A move
  • An illness
  • A job or career change
  • The loss of a loved one
  • A divorce
  • Financial challenges
  • Relationship problems
A key feature of adjustment disorder is that the symptoms are often unexpectedly severe or out of proportion to what’s causing them. 

These symptoms usually start within three months of a stressor and don’t appear to be due to grief or another underlying cause.

Symptoms of adjustment disorder are often intense enough to affect people’s ability to work and function in daily life. Some common examples include the following:

  • Feelings of sadness, hopelessness, stress, or anxiety
  • Changes in eating habits
  • Difficulty sleeping
  • Withdrawal from friends and loved ones
  • Impulsiveness or irritability
  • Lack of motivation to take care of responsibilities
  • Trouble concentrating
  • Conflicts at school, work, or home

While adjustment disorder is a distinct diagnosis, it may be genetically linked to other mental illnesses. In a 2023 study, researchers compared the genetic patterns of adjustment disorders with other mental disorders. They found that adjustment disorder seemed to be genetically associated with anxiety, depression, bipolar disorder, and schizophrenia

What is post-traumatic stress disorder (PTSD)?

Post-traumatic stress disorder (PTSD) is a mental illness triggered by trauma. Trauma can look different for different people, and not everyone who experiences trauma will go on to develop PTSD

Post-traumatic stress disorder (PTSD) symptoms

PTSD can develop after someone witnesses or experiences a traumatic event, and those who do may develop a variety of physical, emotional, and behavioral symptoms listed below that can significantly affect daily life.

  • Panic attacks
  • Flashbacks of the event
  • Nightmares
  • Physical symptoms like headaches, muscle pains, or stomach issues
  • Trouble sleeping
  • Mood swings, irritability, or angry outbursts
  • Nervousness or a sense of being “on edge”
  • Risk-taking behavior
  • Dependence on alcohol or substances
  • Negative beliefs about themselves, others, or the world

People may be at risk of PTSD after witnessing or experiencing life-threatening or violent situations. Some common examples include the following:

  • Physical or sexual assault
  • Combat
  • Natural disasters
  • Extreme injuries or accidents
  • Terrorist attacks

Symptoms of PTSD often start within the first few weeks after a traumatic event, although PTSD can sometimes take months or years to fully develop. People with PTSD may notice significant changes in their motivation, work life, and interactions with others. These can make it difficult to function and may contribute to other mental illnesses, like depression and anxiety. 

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Adjustment disorder vs. PTSD: Exploring the key differences

As you can see, PTSD and adjustment disorder tend to have some common features. However, they are two separate mental illnesses. Telling them apart can be challenging, so this section provides an overview of some of their biggest differences. 

Causes

Like PTSD, adjustment disorder can be caused by stressful events. However, the severity of the event is often a major difference. Adjustment disorders tend to be connected to more common stressors, like moves, job changes, and other life transitions. The traumatic events causing PTSD tend to be more severe. They are usually more likely to involve violence or physical danger. 

Symptoms

PTSD and adjustment disorder may have overlapping symptoms, like mood changes and trouble sleeping. However, people with PTSD may also experience flashbacks or nightmares about the traumatic event. As a result, they may go out of their way to avoid anything that might remind them of the trauma. 

Types

PTSD and adjustment disorder have different subtypes outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). These are typically based on the type of symptoms a person is experiencing. Types of adjustment disorders may include those discussed below: 

  • Depressed mood: In general, this form of adjustment disorder has depression as its main symptom. People may cry often or experience feelings of sadness or hopelessness. 
  • Anxiety: This subtype typically has anxiety as its main symptom. People with this type of adjustment disorder may feel nervous, tense, or jittery. They may experience trembling or shaking or have frequent worries about the future. 
  • Mixed anxiety and depression: People with this type of adjustment disorder may experience symptoms of both anxiety and depression. 
  • Disturbance of conduct: This type of adjustment disorder normally has behavior challenges as its main symptom. People with this subtype might get into fights, stop going to school or work, get into legal trouble, or behave recklessly.
  • Mixed disturbance of emotions and conduct: This form of adjustment disorder can involve both behavioral symptoms and symptoms of anxiety or depression. 
  • Unspecified: This subtype may be given to people whose symptoms don’t fit any of the other categories of adjustment disorders. 

In contrast, the DSM-V lists the following variations of PTSD:

  • With depersonalization: If a person with PTSD experiences depersonalization, they may have frequent sensations of unreality. They might sense they are “outside themselves” or that they are observing their thoughts and actions from a distance. 
  • With derealization: Derealization as a PTSD symptom can involve a person sensing they are disconnected from their surroundings. They might see the world around them as being distorted or dreamlike. 
  • With delayed expression: This variation is typically used to describe PTSD that develops after a delay of six months or more.  

Timeline for adjustment disorder vs PTSD

The timeline of symptoms can be another indicator of whether someone is experiencing adjustment disorder or PTSD. Adjustment disorder usually develops within three months of a stressful life event, and it tends to resolve within six months

On the other hand, PTSD may take a longer time to appear. Symptoms of PTSD may last months or years, especially if left untreated. 

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Treating PTSD and adjustment disorder is possible

Getting help for adjustment disorder and PTSD

Understanding the differences between these two conditions can be useful. However, only a licensed mental health professional can accurately diagnose either one. 

PTSD and adjustment disorders can be distressing, but they are often treatable. That’s why, if you’re experiencing symptoms that concern you, you may want to talk to a doctor. They may be able to recommend a treatment plan that’s right for you. This may include prescription medications, like selective serotonin reuptake inhibitors (SSRIs), community support programs, and other management strategies. 

Your doctor may also recommend therapy to help you manage your symptoms, change negative thought patterns, and improve your overall mental health. Working with a therapist can be a source of ongoing support as you start your recovery journey. 

Benefits of online therapy

Whether you’re living with PTSD or adjustment disorder, therapy can be a highly personal experience. Finding a therapist with whom you feel comfortable opening up may make it easier to stick to counseling long-term and make positive changes. This can sometimes take trial and error, which is why online therapy may be helpful. Platforms like BetterHelp often let you change therapists at any time, for any reason, at no additional cost. 

Effectiveness of online therapy for mental health disorders

Research has found that online therapy can be an effective treatment for both PTSD and adjustment disorder. In 2017, researchers analyzed details from 373 studies of internet-based therapy. They found that online therapy was usually helpful for people with mental illnesses like PTSD, adjustment disorder, anxiety disorder, and depression

Takeaway

PTSD and adjustment disorder are two mental illnesses that can develop due to stressful events. PTSD often develops due to traumatic events, such as violence or sexual abuse. On the other hand, adjustment disorder tends to develop due to more common life stressors, like career changes or moves. Adjustment disorder and PTSD both have different subtypes based on symptoms. Their duration and timelines tend to be different, with adjustment disorder usually being more temporary than PTSD. 

If you’re experiencing symptoms of either of these conditions, a mental health professional may be able to give you more insight. Both adjustment disorder and PTSD can often be managed with proper treatment, including online or in-person therapy.

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