What Is The Difference Between PTSD And Adjustment Disorder?

What is adjustment disorder (stress response syndrome)?

Adjustment disorders refer to a group of symptoms you experience in response to a stressful life event. The stressor could be a particular diagnosis, life event, or relationship difficulties. An adjustment disorder is more common in children and adolescents. 

While a stress response is typical in these situations, it can become an issue. Generally, people respond to stress and gradually learn to cope or address the problem. 

This minimization of stress does not occur with adjustment disorder. Instead, it persists, impacting your ability to participate in your day-to-day life. It can cause physical and psychological symptoms. 

Symptoms of adjustment disorder

The signs of adjustment disorder overlap with other conditions, and they vary significantly from person to person, making it tricky to diagnose. Some include: 

• Frequent crying

• Difficulty sleeping

• Loss of appetite

• Difficulty concentrating

• Feeling overwhelmed

• Avoidance of family, friends, and loved ones

• Anxiety and nervousness

• Self-harm

• Suicidal thoughts

Causes and risk factors of adjustment disorders

There isn’t a single direct cause of adjustment disorders. Your reaction to a stressful event can depend on your past experiences, temperament, support network, and vulnerability. Risk factors include:  

• Getting married

• Financial difficulties

• Death of a family member or friend

• Relationship issues

• Losing your job

Diagnosis of adjustment disorders

If you think you have symptoms of adjustment disorder, speak to your doctor. There is no specific lab test that diagnoses the condition. Instead, your doctor will undertake comprehensive medical, social, and mental health histories. 

This is to identify your emotions, behaviors, life events, and the potential stressor that causes your adjustment disorder. 

There are different types of adjustment disorders, including: 

• Adjustment disorder with depressed mood: Symptoms include hopelessness and tearfulness.

• Adjustment disorder with anxiety: Symptoms include nervousness and worry.

• Adjustment disorder with depressed mood and anxiety: Symptoms of both conditions are present.

• Adjustment disorder with disturbed conduct: Symptoms include fighting and reckless driving.

• Adjustment disorder unspecified: This diagnosis is appropriate when the other subtypes of adjustment disorders do not apply. This type may appear as social withdrawal or increased inhibitions towards normal activities. 

Treatment of adjustment disorders

Adjustment disorders vary from person to person, so there is not a one-size-fits-all treatment approach. An adjustment disorder diagnosis is not something to take lightly: The condition is apparent in up to one-third of young people who die by suicide. 

If left untreated, adjustment disorders can develop into major psychiatric illnesses.¹ An adjustment disorder can go away on its own if you learn to adapt to the situation or remove the trigger.

The good news is that an adjustment disorder generally does not last longer than six months.² 

Treatment options include: 

Psychotherapy

Therapy supports your return to normal life and understanding why the stressful event impacted you.

Medications

Your doctor may prescribe antidepressants and anti-anxiety medication to ease depression and anxiety symptoms.

Lifestyle changes

Adopting lifestyle changes can build your resilience. These may look like maintaining a healthy balance of activities, keeping up your social life, doing things you love, and developing coping strategies for when stressors arrive. 

What is post-traumatic stress disorder (PTSD)?

Post-traumatic stress disorder³ is a condition that arises after witnessing or experiencing a traumatic event. Generally, symptoms of PTSD start within three months of the traumatic event but sometimes appear later. 

The DSM-III first described PTSD in 1980.⁴ It is a serious condition that requires treatment in the form of therapy, medication, or a combination. 

Symptoms of PTSD

• Nightmares or flashbacks

• Avoiding reminders of the trauma

• Difficulty sleeping

• Loss of interest in activities

• Emotional detachment or difficulty controlling your emotions

• Feelings of anger, irritability, or anxiety

• Overwhelming guilt or shame

• Difficulty relating to others

Causes and risk factors of PTSD

• Serious accidents

• Physical or sexual assault

• Surviving a natural disaster

• Traumatic childbirth

• Seeing people hurt or killed

• Combat veterans 

Diagnosis of PTSD

To receive a PTSD diagnosis, you must have one or more of the following symptoms for over one month: 

• At least one re-experiencing symptom, including flashbacks, nightmares, and intrusive thoughts or feelings

• At least one avoidance symptom, including avoiding things that remind you of the trauma and ignoring your feelings

• At least two cognition and mood symptoms, including depression, anxiety, phobias, suicidal ideation, negative thoughts, and feeling guilty

• At least two arousal and reactivity symptoms, including feeling on edge, hypervigilance, irritability, angry outbursts, difficulty sleeping and concentrating

Treatment of PTSD

When treating PTSD, your doctor will need to consider if you have any comorbid conditions they should address. PTSD is a debilitating condition, and effective treatment is vital to allow you to regain control over your life. 

Psychological therapy

There are a few types of therapies available:

Cognitive behavior therapy (CBT)

CBT⁵ helps you come to terms with the traumatic event and gain control over the distress you may feel when confronting the experience you had. Studies have identified that daytime PTSD symptoms improve after just one CBT session. 

Eye movement desensitization and reprocessing (EMDR)

EMDR works by having you recall the traumatic event in detail while making eye movements. Scientists believe it reshapes how you think about the traumatic experience.

Prolonged exposure therapy (PE)

PE teaches you to gradually and safely tackle your trauma-associated memories and emotions. 

Medicines

Paroxetine⁶ and sertraline⁷ are both recommended for treating PTSD. These are selective serotonin reuptake inhibitors (SSRIs) that increase the amount of serotonin in your brain. 

How common are these conditions? 

Research on the frequency of adjustment disorders is limited. Current research¹ has estimated their prevalence is around 0.9%. 

According to the National Center for PTSD, five out of every ten women and six out of every ten men⁸ experience at least one trauma in their lives. Around 4%⁹ of the general global population will have PTSD at some point. In people with known exposure to trauma, the rate is 5.6%. 

When to see a doctor

Both of these disorders can significantly impact your mental and physical health. Therapy can be highly beneficial. Doctors sometimes prescribe medication to treat associated conditions, including anxiety, depression, and sleeping difficulties. 

Support groups can also be a highly beneficial resource for understanding the disorder and addressing symptoms. If you are experiencing any symptoms, speak to your doctor to see what the best course of action is for you. 

If you are experiencing either of these conditions, remember that you are not alone, and reach out to the people close to you for support. 

The lowdown 

While adjustment disorder and PTSD may seem similar, they have different causes, symptoms, and treatment options. It’s important to get help from your health professional and reach out for support if you think you have either of these disorders.