Adjustment Disorder vs Depression

Sometimes the symptoms of depression can be murky, and it can be hard to tell if what you’re feeling is an adjustment disorder — or depression.

It’s normal to feel stressed, sad or hopeless after experiencing a major setback or going through a difficult period in your life. 

Sometimes, the stress and frustration of a negative life event can result in persistent depression that lasts for months at a time. In other cases, it can cause shorter-acting symptoms that appear similar to those of clinical depression.

If you’ve recently gone through a stressful, difficult life experience and now feel upset, hopeless or anxious, you may have what’s called an adjustment disorder.

Below, we’ve discussed what adjustment disorders are, as well as how an adjustment disorder differs from clinical depression. 

We’ve also explained the options that are available to help you overcome your symptoms, feel better and enjoy a higher quality of life. 

The term “adjustment disorder” refers to a group of psychological and physical symptoms that can develop after traumatic, stressful events. This type of disorder might develop if you find it difficult to cope with a sudden change — often negative — that occurs in your life. 

A variety of issues can cause or contribute to adjustment disorders, including financial worries, the end of a relationship, losing a loved one, experiencing a sudden setback in life, or suffering from a severe illness or other health issue.

Sometimes, a simple change of your environment and social life, such as moving to a new city or region, can play a role in the development of an adjustment disorder.

In children, teens and young adults, ongoing, identifiable stressors such as problems at school, family issues and concerns about sexuality can also contribute to adjustment disorders.

Adjustment disorders can cause a range of emotional and behavioral symptoms, some of which can be severe. Common symptoms associated with adjustment disorders include:

• Feelings of sadness and hopelessness

• Crying, social withdrawal and other changes in behavior

• Feeling and behaving tense or nervously

• Showing defiant and/or impulsive behavior

• An abnormal heartbeat, trembling and other physical issues

When severe, adjustment disorders can even involve thoughts of death and/or suicide. Some people affected by adjustment disorders may self harm or attempt suicide.

To diagnose adjustment disorders, mental health professionals will look for symptoms that first develop within three months of a stressful life event. 

These symptoms are generally more severe than expected and aren’t caused by an underlying health issue, such as a psychological disorder or physical health problem.

Major depressive disorder, or clinical depression, is a serious mental health disorder that affects the way you think, feel and behave. It affects an estimated 21 million people in the US alone, or 8.4 percent of all US adults. 

Depression can cause severe, persistent symptoms that affect your wellbeing, quality of life and even your physical health. Common symptoms of depression include:

• Persistent feelings of emptiness, sadness and anxiety

• Reduced interest in your normal hobbies and activities

• Loss of pleasure from activities that you normally enjoy

• Irritability and a “shorter fuse” around other people

• A pessimistic, hopeless attitude towards life

• Feeling like you’re worthless, guilty or unable to be helped

• Difficulty staying still and a general feeling of restlessness

• Slowed physical movements and/or speech

• Difficulty falling asleep, staying asleep or waking up

• Low levels of energy and a general feeling of fatigue

• Difficulty focusing on tasks and remembering information

• A reduced ability to take action and make decisions

• Changes in your appetite, eating habits and/or body weight

• Physical pains, cramps and other symptoms without an obvious cause

• Suicidal thoughts and/or behavior 

To be diagnosed with clinical depression, you’ll need to have several symptoms in addition to a depressed mood that occur on a daily or near-daily basis for two weeks or longer.

Experts aren’t aware of precisely what causes depression. However, current research suggests that environmental, psychological and biological factors, including your genes, are all involved in its development.

You may be more at risk of becoming depressed if one of your family members has depression, if you have a physical, or if you use some types of medication. Like with adjustment disorders, stressful or traumatic events may also play a role in the development of clinical depression. 

Adjustment disorders and depression can often involve similar symptoms. In fact, the symptoms of adjustment disorders are commonly mistaken for mental disorders such as major depression, acute stress disorder, bipolar disorder, posttraumatic stress bipolar disorder and others.

Despite these similarities, there are several important differences between adjustment disorders and clinical depression:

• Adjustment disorders are usually short term. It’s uncommon for adjustment disorders to last for longer than six months, provided the source of stress is identified and removed from your daily life.In contrast, depression can potentially be a lifelong mental illness. Many people affected by depression have severe symptoms that don’t go away without ongoing treatment and require long-term help to prevent relapse.
  

• Most adjustment disorders improve with therapy alone. For most people, therapy is the preferred form of treatment for adjustment disorders. One particularly common form of therapy is cognitive behavioral therapy (CBT).Depression also improves with therapy. However, your mental health provider may also prescribe an antidepressant to provide additional relief from your symptoms.
  

• Adjustment disorders usually occur in children and adolescents. People of all ages can be affected by adjustment disorders, but they’re particularly common in children and adults. Clinical depression can also occur in adolescents. It’s most common in people aged from 18 to 25, but can affect people of all ages and backgrounds.
  

• Most of the time, adjustment disorders have an identifiable cause. Most adjustment disorders have an obvious, identifiable cause, such as a traumatic event, life-threatening experience or simply the stress of starting life in a new location.In contrast, depression can develop without a clear cause. Many people with depression start to develop depressive symptoms without a clear “trigger” event, such as a personal setback or other negative experience.
  

• Adjustment disorders are equally common in men and women. Unlike other mental illnesses, which often vary in prevalence by sex, adjustment disorders occur in men and women equally.In comparison, clinical depression is significantly more common in women than in men, with an estimated 10.5 percent of US adult women and 6.2 percent of men affected by depression in 2020.

To determine if you have an adjustment disorder or clinical depression, your healthcare provider may ask you some questions about your symptoms. You may need to complete an assessment to give your provider the information they need for an accurate diagnosis. 

Make sure to give your healthcare provider as much information as possible so that they’re able to understand your symptoms and recommend the most effective form of treatment.

Both adjustment disorders and clinical depression can cause severe symptoms that affect your feelings, mental function and daily life. The good news is that both issues are treatable, usually with therapy, medication, changes to your habits or a combination of approaches.

Treatments for Adjustment Disorder

If you have an adjustment disorder, your mental health provider may suggest that you take part in psychotherapy, or talk therapy.

This form of therapy involves identifying stressors and taking steps to stop them from triggering a negative response. Your mental health provider may suggest participating in therapy on your own, as part of family therapy or in a self-help group. 

In some cases, you may be prescribed medication to manage the symptoms of your adjustment disorder or to treat issues such as difficulty sleeping.

Most adjustment disorders improve quickly with therapy and support, especially once the causal stressor is identified and removed. 

Treatments for Depression

If you have clinical depression, your healthcare provider will likely prescribe a type of medication called an antidepressant to reduce the severity of your symptoms.

Antidepressants work by increasing your levels of certain neurotransmitters — natural chemicals that are responsible for regulating your moods and stress levels. It may take several weeks for your antidepressant to produce noticeable improvements in your symptoms.

Common types of antidepressants include selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). 

Depression is also often treated with psychotherapy, including interpersonal therapy, cognitive behavioral therapy and problem-solving therapy. Your mental health provider may suggest a combination of therapy and medication to control your symptoms and help you recover. 

Healthy Habits for Feeling Better

If you have an adjustment disorder or a form of depression, your mental health provider may suggest making changes to your habits and lifestyle. 

Sometimes, even small changes to your daily routine can have a big impact on your thoughts, feelings and moods. Try making the following changes while you’re treating your depression or adjustment disorder:

• Keep yourself physically active. Exercise can improve your moods and reduce the severity of some depression symptoms by promoting the release of natural feel-good chemicals called endorphins.
  

• Spend time with friends and family members. It’s easy to become isolated when you’re depressed. Set aside plenty of time to spend with your close friends and family, and don’t feel hesitant to confide in them if you need to.
  

• Focus on making gradual, steady progress. Overcoming an adjustment disorder or recovering from depression can be a slow process. Focus on making gradual progress, not on overnight improvements.
  

• Avoid making tough decisions while you’re feeling low. When you’re not feeling your best, it can be difficult to make major life decisions. Try to delay these until you’re feeling more stable and confident in your decision-making skills. 

Our list of self-help strategies for depression shares other proven techniques to help you deal with your symptoms and make progress toward recovery. 

Whether you have an adjustment disorder or depression — both can have a major impact on your thoughts, feelings and behavior. When severe, they can cause you to doubt yourself and even develop suicidal thoughts. 

If you’ve noticed symptoms that could be caused by an adjustment disorder or depression, it’s important to seek help from a mental health professional.

You can get help by asking your primary care provider for a mental health referral, scheduling an appointment with a psychiatrist in your area, or from home using our range of online mental health services. 

If you think you may be clinically depressed, you can talk to a licensed psychiatry provider and undergo an assessment using our online psychiatry service. 

You’ll receive a personalized treatment plan that, if appropriate, may include medication to treat your symptoms and help you work toward recovery.