Adjustment Disorder

Adjustment disorder is a reaction to stress and can persist for more than a few months after the stressful event.

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​Most people struggle to cope with stress and change at times, but an adjustment disorder refers to significant distress that persists for more than a few months after the stressful event. This reaction to stress can interfere with everyday tasks such as studying and working, and with enjoyment of life in general.


The main symptoms of an adjustment disorder in children and youths could be emotional or behavioural, or a combination of both, and include:

• Feelings of sadness, hopelessness, worry, nervousness, fear, irritability or anger

• Unexplained body aches and pains, poor sleep or poor appetite

• Clinginess to major attachment figures (fear of separation)

• Withdrawal from family and friends

• Problems at school or with schoolwork

• Truancy, fighting or other acting out or reckless behaviours

• Self-harming behaviours

• Thoughts of or attempts at suicide


While they can resemble and be just as distressing or disruptive as symptoms of depression, anxiety or a behavioural disorder, the symptoms of an adjustment disorder are generally not as severe.


What Causes an Adjustment Disorder?

The main cause of an adjustment disorder is a recent stressful life event, but individual stress responses vary significantly. An event that one person finds overwhelming may seem trivial to another. The temperament, coping skills, past experiences, current developmental stage and social support systems of children and youths all contribute to their ability to respond to stress.


Sources of stress also differ in duration, intensity and magnitude.


Common sources of stress for children or adolescents include:

• The break-up of a friendship or a romantic relationship

• Early onset of puberty

• Getting into an accident

• Being diagnosed with a medical illness

• Parental separation or divorce, loss of a family member or family conflict

• Moving to a new home, community or country

• Stressful school experiences such as being bullied, facing major examinations or changing schools


How do You Manage an Adjustment Disorder?

Specific treatment by a clinician may not always be required. With support from family and friends or from a counsellor, symptoms may go away in a few months. If symptoms are particularly distressing and debilitating, one or a combination of the following treatments may be helpful:


1. Psychological Intervention

These therapies can help your child better understand what an adjustment disorder is and learn ways to manage the symptoms. One commonly used type of psychotherapy involves helping your child identify and challenge unhelpful thoughts and beliefs that contribute to how he or she is feeling. Your child will also learn skills for coping, problem-solving and anger or stress management.


2. Family Intervention

It may also be helpful for parents or other family members to receive therapy to address parental or family issues that may affect the child’s ability to cope with his or her circumstances.


3. Use of Medication

Typically, doctors do not prescribe medication to treat children or adolescents with an adjustment disorder. However, in some instances, certain medications may be prescribed in the short term. Talk to your child’s doctor if you have any queries or concerns about medication.


You can also help your child by being patient, understanding and supportive. Be encouraging and empathise with his or her challenges. Celebrate all small successes and be positive. If the source of stress is school-related, you can talk to your child’s teachers or school counsellors for help.




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