We’ve all been told that “change is the only constant in life.” But while some changes, like moving away from home, are expected, others can be jarring. If you’re finding it hard to adjust to these transitions, you’re not alone.
Whether it’s the end of a relationship, the loss of a job, or a serious health diagnosis, certain events or ongoing situations can upend life as you knew it. In some cases, they may lead to emotional and behavioral responses that feel overwhelming, bringing on a response known as an Adjustment Disorder.
But how do you know if what you’re going through is just a rough patch, or a mental health condition that could benefit from professional support? Read on to find out.
What is Adjustment Disorder?
Adjustment Disorder is a mental health condition that occurs when life’s challenges or big changes feel harder to manage than usual. More than just feeling stressed, your emotions or behaviours can feel more intense or prolonged than usual and start to affect your daily life, relationships, or work.
What causes Adjustment Disorder?
Adjustment Disorder is a response to stressors that disrupt your sense of balance. It could be:
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- A single event (e.g. the end of a relationship or losing a job)
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- Multiple challenges happening at once (e.g. financial problems and family conflict)
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- Recurring (e.g. seasonal work pressures or ongoing relationship difficulties)
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- Continuous (e.g. chronic illness or living in an unsafe environment)
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- Major life transitions (e.g. starting school, becoming a parent, or retiring)
Adjustment Disorder can affect individuals, families, or whole communities, especially after major events like natural disasters. It’s also important to remember that people facing tougher life circumstances often experience more stress and may be more vulnerable to developing Adjustment Disorder.
Adjustment Disorder and grief
Grief is a natural and personal response of losing a loved one, but when feelings of distress are unusually intense or prolonged, it may be indicative of Adjustment Disorder. In some cases, grief can become more persistent and complex, leading to what is known as Prolonged Grief Disorder, a form of grief that requires extra support and care.
Adjustment Disorder symptoms
Here are some key signs that may point to Adjustment Disorder:
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- You experience strong emotional or behavioural reactions soon after a specific stressful event or situation begins (usually within three months). (e.g. feeling hopeless and struggling to get out of bed after losing a job)
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- You experience significant distress that feels overwhelming relative to the situation, considering your culture and background. (e.g. being unable to eat or sleep for weeks after a break-up)
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- Your symptoms make it hard to function well at work, school, or in your relationships. (e.g. missing deadlines at work or cancelling social plans because you find it difficult to focus or be around others)
If you’ve suffered a loss, these reactions often go beyond normal grief or sadness. They also aren’t better explained by another mental health condition or a worsening of an existing one.
How long does Adjustment Disorder last?
In Adjustment Disorder, emotional and behavioural reactions tend to improve within about six months once the situation changes or settles. If the stressor is ongoing, the diagnosis may remain. However, if the stressor has been resolved but symptoms persist beyond six months, your clinician may consider alternative diagnoses.
Effects of Adjustment Disorder
Adjustment Disorder often leads to struggles at work or school, like falling behind on tasks or finding it hard to focus. Relationships may also feel strained if you withdraw or become more short-tempered. For those dealing with medical issues, it can even make following treatment harder and slow recovery. But with the right support, most people bounce back from Adjustment Disorder and find ways to manage stress better in the future.
Additionally, individuals with Adjustment Disorder have an increased risk of suicide, highlighting the need for early diagnosis and intervention. If you’re experiencing distress or thoughts of self-harm, please reach out to a crisis line or trusted professional.
How is Adjustment Disorder diagnosed?
Adjustment Disorder is more common than many realise. It accounts for an estimated 5% to 20% of diagnoses in outpatient mental health settings, and is often the most frequently diagnosed condition (with rates as high as 50%) in hospital psychiatric consultations.
Diagnostic process
Diagnosing Adjustment Disorder begins with a conversation with a psychologist. They’ll take time to understand what’s changed in your life recently, how you’ve been feeling, and how those feelings may be affecting your ability to function day to day. To paint a fuller picture of your situation, you may also be asked about your medical history, past mental health experiences, and the support systems in your life.
A key part of diagnosing Adjustment Disorder is identifying a specific stressor and determining if your emotional and behavioural responses feel more intense or long-lasting than what’s typically expected.
Because reactions to stress can vary greatly from person to person, clinicians also take your cultural background into account. For example, while moving out of the family home is often seen as a normal part of growing up in some cultures, it can feel like a rupture in connection in collectivist cultures. Similarly, in many Asian cultures, adult children caring for aging parents may experience caregiver burnout. Feelings of overwhelm in these contexts may reflect cultural expectations around filial piety rather than indicate a psychological disorder.
To ensure an accurate diagnosis, your provider will also rule out other possible explanations, such as:
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- Major Depressive Disorder (MDD): When symptoms like low mood or lack of interest are persistent and not clearly tied to a recent life event.
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- Post Traumatic Stress Disorder (PTSD) or Acute Stress Disorder: When symptoms follow a traumatic event and meet specific criteria and timelines.
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- Personality disorders: When symptoms stem from long-term personality patterns rather than a short-term response to stress.
In short, Adjustment Disorder is diagnosed when symptoms are closely tied to a stressor, go beyond what’s culturally expected, and can’t be better explained by another mental health condition.
Specific diagnoses
When diagnosing Adjustment Disorder, psychologists specify the main symptom pattern, including:
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- Adjustment Disorder with depressed mood (feeling sad or hopeless)
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- Adjustment Disorder with anxiety (feeling nervous or worried)
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- Adjustment Disorder with mixed anxiety and depressed mood
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- Adjustment Disorder with disturbance of conduct (acting out or behaving disruptively)
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- Adjustment Disorder with mixed emotional and conduct symptoms
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- Or unspecified, when symptoms don’t fit neatly into one category
This detailed diagnosis helps guide the most appropriate support and treatment.
How is Adjustment Disorder treated?
Short-term talk therapy can help to treat Adjustment Disorder by helping you make sense of your responses to a difficult life event, find healthier ways to cope, and gradually regain a sense of balance and control.
Psychotherapy
Cognitive Behavioural Therapy (CBT)
Cognitive Behavioural Therapy (CBT) is a commonly recommended treatment for Adjustment Disorder. The idea behind CBT is that how we think influences how we feel and act. By identifying and challenging unhelpful thought patterns and behaviours that may be amplifying your stress response, you can begin to shift your emotional experience.
Let’s say you’ve been laid off and are now struggling with intense self-doubt and hopelessness. Through CBT, your therapist might help you notice thoughts like, “I’ll never find work in this job market,” and explore evidence that challenges this belief. You may also work on behavioural strategies, like applying to one job per day, to help rebuild confidence.
Mindfulness-Based approaches
Mindfulness training, which helps individuals with Adjustment Disorder become more aware of their thoughts and emotions in the present moment, has improved psychological symptoms and the quality of life for them. Instead of trying to “fix” or push away uncomfortable feelings, you’ll learn how to sit with them and respond with self-compassion.
For example, if you’ve recently received a difficult health diagnosis, simple practices like mindful breathing, journaling, or even just recognising and labelling your emotions can be a good starting point. Your therapist might also introduce acceptance-based strategies, encouraging you to acknowledge the reality of the situation while making room for emotions like fear, anger, or grief—without judgment.
Over time, this approach can reduce emotional reactivity and help you feel more grounded, even in the face of ongoing challenges.
Medication
Not everyone will need medication; many people find that psychotherapy and other coping strategies are sufficient.
That said, in some cases, especially when symptoms are severe or there’s a risk of self-harm, a psychiatrist may prescribe short-term medication, such as anti-anxiety drugs (like benzodiazepines) or antidepressants (such as SSRIs). The specific emotional symptoms a person is experiencing, such as anxiety or low mood, play an important role in determining whether medication may be helpful.
Healing from Adjustment Disorder at Intellect Clinic
Life can throw us off course in ways we don’t always expect, and even “normal” changes can feel anything but. However, you don’t have to wait until things get worse to reach out.
Adjustment disorder is treatable, and things can get better with short-term psychotherapy or medication. Even if you don’t meet the criteria for a diagnosis, counselling can still help you navigate life’s ups and downs.
50-minute sessions with our counsellors and clinical psychologists are priced at $160 and $240 (Singapore dollars) respectively, and we offer appointments at our clinics in:
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- Marina One
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- Dhoby Ghaut
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- Tanjong Pagar
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- Woodleigh
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- Tembeling
