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While some children areresilient to stressful eventsand other major life changes, others struggle to rebound. A child who exhibits changes in mood or behavior after a stressful life event may have an adjustment disorder.

An adjustment disorder is a mental health condition that may require professional help. With appropriate intervention, adjustment disorders usually respond well to treatment.

Causes

People of all ages can haveadjustment disorders, but they’re especially common in children and adolescents.

The stressful situation may be a one-time event, like the death of a pet. But an adjustment disorder may also stem from an ongoing stressful situation, such as being bullied repeatedly at school.

Not all children who experience stressful events develop adjustment disorders, however. And what one child considers stressful might not be a big deal to another. So while one child might develop an adjustment disorder after the parents’ separation, another child in the same family may not experience the same response.

Several factors, such as the child’s temperament and past experiences, influence whether a child develops an adjustment disorder after a stressful event. A strong support system and healthy coping skills may serve as protective factors that reduce the chances a child will develop an adjustment disorder.

Subtypes

There are several subtypes of adjustment disorders and the diagnosis depends on the child’s emotional symptoms and behavior following a stressful event. The specific subtypes are:

It’s important to note that just because your child has been diagnosed with an adjustment disorder with depressed mood, it doesn’t mean he’s been diagnosed with “clinical depression.” By their definition, adjustment disorders are stress-related conditions that do not meet the full criteria for another mental disorder. That can be confusing for parents, but it’s an important distinction.

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Symptoms

Just because a child is having trouble adjusting to a new circumstance or a stressful situation doesn’t necessarily mean the child has a diagnosable mental health condition. In order to qualify for a diagnosis of adjustment disorder, a child’s impairment must be beyond what would be considered normal for the circumstances.

An adjustment disorder will impair a child’s social or academic functioning. A decline in grades, trouble maintaining friendships, or an unwillingness to go to school are a few examples. Adolescents may exhibit anti-social behavior, such as vandalism or stealing.

Children with adjustment disorders frequently report physical symptoms, such as stomachaches and headaches. Sleep problems and fatigue are common as well. Symptoms must appear within three months of a specific stressful event.

But symptoms cannot last for more than six months. If a child experiences ongoing symptoms after six months, the situation would qualify for the diagnosis of a different disorder, such as diagnosis ofgeneralized anxiety disorderormajor depression.

It is possible for children to experience a comorbid condition. For example, a child who has previously been diagnosed withADHDoroppositional defiant disordermay also experience an adjustment disorder after a stressful event.

Risk for Suicide

Even though an adjustment disorder is brief, it can still be extremely serious. Adolescents who are experiencing high degrees of distress are at a higherrisk for suicide.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see ourNational Helpline Database.

Approximately 25% of teens with an adjustment disorder experience thoughts of suicide or make a suicide attempt. Studies show girls with adjustment disorders show higher suicidal tendencies than boys with the same diagnosis.

If your child expresses thoughts about wanting to die or she makes any attempt to harm herself, take the situation seriously. Never assume your child is merely being dramatic or trying to get attention. Contact your child’s pediatrician or a mental health professional if your child expresses thoughts of suicide. If the situation is an emergency, call 911 for first-responders or go to your local emergency room.

Diagnosis

A physician or mental health professional can diagnose an adjustment disorder. As part of a comprehensive assessment, the parents and the child are usually interviewed. If the child meets the criteria and other conditions are able to be ruled out, a diagnosis of adjustment disorder may be given.

The physician or mental health professional will ask questions about a child’s emotions, behavior, development, and the identified stressful event. In some cases, a teacher, caregiver, or other service provider may be asked to provide further information.

Treatment

The type of treatment a child with an adjustment disorder needs depends on several factors, such as the child’s age, the extent of the symptoms, and the type of stressful event that took place.

A healthcare professional will create a customized treatment plan with specific recommendations. When necessary, a child may be referred to other specialists, like a psychiatrist. Here are some of the most common treatments for an adjustment disorder:

Early intervention can be instrumental in treating adjustment disorder and may prevent the disorder from turning into a more serious condition, like major depression.

Treatment is usually effective for adjustment disorders. If a child does not respond well to one type of treatment, a mental health professional may try another approach.

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If You Think Your Child Has an Adjustment Disorder

Symptoms of an adjustment disorder may begin slowly. Your child may complain about a stomach ache one week and cry about having to go to school the next.

Don’t brush off the changes in mood or behavior as a phase. Without appropriate intervention, symptoms of an adjustment disorder are likely to get worse.

If you have concerns about your child’s mood or behavior, ask other caregivers what they notice. A teacher, daycare provider, or coach will be able to offer insight into whether your child is having problems in other areas.

If you notice changes in your child’s mood or behavior, and the changes last more than two weeks, schedule an appointment with your pediatrician. Share your concerns and discuss your options.

Even if you can’t identify a stressful event that your child has endured, he may still have an adjustment disorder based on an event that occurred. Perhaps something happened at school or in another person’s home when he was visiting. Or an event that you didn’t find stressful may have had a bigger impact on your child.

And even if what is going on with your child isn’t diagnosed as an adjustment disorder, a change in your child’s mood or behavior could be a sign of another condition.

A physician will rule out any potential physical health problems that may be behind the changes and, if warranted, a referral may be made to a mental health professional.

6 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Yaseen YA.Adjustment disorder: Prevalence, sociodemographic risk factors, and its subtypes in outpatient psychiatric clinic.Asian J Psychiatr. 2017;28:82-85. doi:10.1016/j.ajp.2017.03.012Bachem R, Casey P.Adjustment disorder: A diagnosis whose time has come.J Affect Disord.2018;227:243-253. doi:10.1016/j.jad.2017.10.034Zimmerman M, Martinez JH, Dalrymple K, Martinez JH, Chelminski I, Young D.Is the distinction between adjustment disorder with depressed mood and adjustment disorder with mixed anxious and depressed mood valid?.Ann Clin Psychiatry.2013 Nov;25(4):257-265.Zimmerman M, Martinez JH, Dalrymple K, Chelminski I, Young D.“Subthreshold” depression: is the distinction between depressive disorder not otherwise specified and adjustment disorder valid?.J Clin Psychiatry.2013;74(5):470-476. doi:10.4088/JCP.12m08053Doherty AM, Jabbar F, Kelly BD, Casey P.Distinguishing between adjustment disorder and depressive episode in clinical practice: the role of personality disorder.J Affect Disord.2014;168:78-85. doi:10.1016/j.jad.2014.06.034Ferrer L, Kirchner T.Suicidal Tendency in a Sample of Adolescent Outpatients With Adjustment Disorder: Gender Differences.Comprehensive Psychiatry. 2014;55(6):1342-1349. doi:10.1016/j.comppsych.2014.04.017Additional ReadingAmerican Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(DSM–5). Fifth edition. Arlington, Va.: American Psychiatric Association; 2013.

6 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Yaseen YA.Adjustment disorder: Prevalence, sociodemographic risk factors, and its subtypes in outpatient psychiatric clinic.Asian J Psychiatr. 2017;28:82-85. doi:10.1016/j.ajp.2017.03.012Bachem R, Casey P.Adjustment disorder: A diagnosis whose time has come.J Affect Disord.2018;227:243-253. doi:10.1016/j.jad.2017.10.034Zimmerman M, Martinez JH, Dalrymple K, Martinez JH, Chelminski I, Young D.Is the distinction between adjustment disorder with depressed mood and adjustment disorder with mixed anxious and depressed mood valid?.Ann Clin Psychiatry.2013 Nov;25(4):257-265.Zimmerman M, Martinez JH, Dalrymple K, Chelminski I, Young D.“Subthreshold” depression: is the distinction between depressive disorder not otherwise specified and adjustment disorder valid?.J Clin Psychiatry.2013;74(5):470-476. doi:10.4088/JCP.12m08053Doherty AM, Jabbar F, Kelly BD, Casey P.Distinguishing between adjustment disorder and depressive episode in clinical practice: the role of personality disorder.J Affect Disord.2014;168:78-85. doi:10.1016/j.jad.2014.06.034Ferrer L, Kirchner T.Suicidal Tendency in a Sample of Adolescent Outpatients With Adjustment Disorder: Gender Differences.Comprehensive Psychiatry. 2014;55(6):1342-1349. doi:10.1016/j.comppsych.2014.04.017Additional ReadingAmerican Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(DSM–5). Fifth edition. Arlington, Va.: American Psychiatric Association; 2013.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Yaseen YA.Adjustment disorder: Prevalence, sociodemographic risk factors, and its subtypes in outpatient psychiatric clinic.Asian J Psychiatr. 2017;28:82-85. doi:10.1016/j.ajp.2017.03.012Bachem R, Casey P.Adjustment disorder: A diagnosis whose time has come.J Affect Disord.2018;227:243-253. doi:10.1016/j.jad.2017.10.034Zimmerman M, Martinez JH, Dalrymple K, Martinez JH, Chelminski I, Young D.Is the distinction between adjustment disorder with depressed mood and adjustment disorder with mixed anxious and depressed mood valid?.Ann Clin Psychiatry.2013 Nov;25(4):257-265.Zimmerman M, Martinez JH, Dalrymple K, Chelminski I, Young D.“Subthreshold” depression: is the distinction between depressive disorder not otherwise specified and adjustment disorder valid?.J Clin Psychiatry.2013;74(5):470-476. doi:10.4088/JCP.12m08053Doherty AM, Jabbar F, Kelly BD, Casey P.Distinguishing between adjustment disorder and depressive episode in clinical practice: the role of personality disorder.J Affect Disord.2014;168:78-85. doi:10.1016/j.jad.2014.06.034Ferrer L, Kirchner T.Suicidal Tendency in a Sample of Adolescent Outpatients With Adjustment Disorder: Gender Differences.Comprehensive Psychiatry. 2014;55(6):1342-1349. doi:10.1016/j.comppsych.2014.04.017

Yaseen YA.Adjustment disorder: Prevalence, sociodemographic risk factors, and its subtypes in outpatient psychiatric clinic.Asian J Psychiatr. 2017;28:82-85. doi:10.1016/j.ajp.2017.03.012

Bachem R, Casey P.Adjustment disorder: A diagnosis whose time has come.J Affect Disord.2018;227:243-253. doi:10.1016/j.jad.2017.10.034

Zimmerman M, Martinez JH, Dalrymple K, Martinez JH, Chelminski I, Young D.Is the distinction between adjustment disorder with depressed mood and adjustment disorder with mixed anxious and depressed mood valid?.Ann Clin Psychiatry.2013 Nov;25(4):257-265.

Zimmerman M, Martinez JH, Dalrymple K, Chelminski I, Young D.“Subthreshold” depression: is the distinction between depressive disorder not otherwise specified and adjustment disorder valid?.J Clin Psychiatry.2013;74(5):470-476. doi:10.4088/JCP.12m08053

Doherty AM, Jabbar F, Kelly BD, Casey P.Distinguishing between adjustment disorder and depressive episode in clinical practice: the role of personality disorder.J Affect Disord.2014;168:78-85. doi:10.1016/j.jad.2014.06.034

Ferrer L, Kirchner T.Suicidal Tendency in a Sample of Adolescent Outpatients With Adjustment Disorder: Gender Differences.Comprehensive Psychiatry. 2014;55(6):1342-1349. doi:10.1016/j.comppsych.2014.04.017

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders(DSM–5). Fifth edition. Arlington, Va.: American Psychiatric Association; 2013.

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