Adjustment Disorder

What is it?

A strong, long-lasting reaction to an upsetting event may be adjustment disorder. Triggering events are ones that are important to your child: divorce, a family death, moving, attending a new school, a break up, or a big life disappointment. A child with adjustment disorder has difficulty controlling emotions and may become depressed or anixious, hostile, pick fights, or refuse to go to school. It can occur in young children, adolescents, and adults.

Signs and Symptoms

Symptoms of adjustment disorder include abnormal anxiety or depression, sleeping problems,  crying spells, avoiding school, becoming isolated from family and friends, irritability, vandalism, and fighting. A child will have a reaction that significantly interferes with daily life.

Diagnosis and Treatment

Children and adolescents diagnosed with adjustment disorder are abnormally upset and unable to cope after a distressing event, significantly affecting academic or social activities. Symptoms would not last more than six months after the stressful event happened.

Adjustment disorder is primarily treated with psychotherapy; in some cases medication may alleviate symptoms. Talk therapy is extremely effective, showing the child that her reaction to stress is within her power to control and allowing her to express her emotions in a supportive environment. Adjustment disorders often affect the whole family, so counseling might include parents and caregivers.  Treatment may take months. Low doses of anti-anxiety medication may help anxiety and behavior problems; antidepressants may help alleviate depression or suicidal thoughts.

What are the risk factors for children?

Children who experience frequent, severe stress are more likely to develop an adjustment disorder. It’s unknown why some are more vulnerable than others who are more resilient.

Your child can outgrow adjustment disorder (if his symptoms have lasted longer than 6 months, it’s not considered adjustment disorder). Adolescents with untreated adjustment disorder are prone to risky behaviors, including violence, alcohol and substance abuse, and are at higher risk for depression and chronic anxiety. Since the anxiety, depression and acting out can disrupt their lives, as well as your family’s, treatment is preferable. Without treatment, a child is more likely to have an unhealthy response to future painful events, rather than developing a coping strategy to handle stress.