Adjustment Disorder Anxiety and Depressed Mood Symptoms Causes and Treatment

Definition and diagnostic criteria

Adjustment disorder with anxiety and depressed mood is a condition diagnosed when emotional or behavioral symptoms occur in response to an identifiable stressor within a close time frame and cause distress or impairment. The symptoms are not better explained by another mental disorder, do not represent normal bereavement, and do not persist beyond six months after the stressor or its consequences have ended. The condition is categorized into specifiers based on predominant symptoms.

According to DSM-5-TR criteria (the standard framework used by professionals), a diagnosis requires:

• The development of emotional or behavioral symptoms within 3 months of the identifiable stressor(s).
• These symptoms or behaviors are clinically significant, as manifested by marked distress out of proportion to the severity or intensity of the stressor, or by significant impairment in social, occupational, or other important areas of functioning.
• The stress-related disturbance does not meet criteria for another mental disorder and is not merely an exacerbation of a preexisting mental disorder.
• The symptoms do not represent normal bereavement.
• Once the stressor or its consequences have terminated, the symptoms do not persist for more than an additional 6 months.

Specifiers commonly observed include:

• With anxiety
• With depressed mood
• With mixed anxiety and depressed mood
• With disturbance of conduct
• With mixed disturbance of emotions and conduct
• Unspecified

Symptoms and signs

People with adjustment disorder may experience a range of emotional, cognitive, physical, and behavioral changes. Because the stress response is personal, symptoms can vary widely. Common presentations include:

• Emotional symptoms: persistent worry, irritability, sadness or hopelessness, tearfulness, feeling overwhelmed, low self-esteem.
• Depressed mood (when present): diminished interest in activities, fatigue, decreased energy, slowed thinking or movements.
• Anxiety-related symptoms (when present): restlessness, excessive worry, difficulty concentrating, sleep disturbances.
• Mixed anxiety and depressed mood: a combination of worry and low mood without meeting criteria for another mood or anxiety disorder.
• Behavioral and social signs: withdrawal from friends or family, decline in performance at work or school, rule-breaking or conduct changes (in some specifiers).
• Physical symptoms: headaches, stomach problems, changes in appetite, sleep problems such as insomnia or hypersomnia.

Symptoms typically begin within a few weeks of the stressor but can vary in onset. They may lessen as the stressor resolves or as coping improves, though in some cases they can persist for several months if stressors continue or if coping resources are limited.

Causes and risk factors

Adjustment disorder is a reaction to identifiable life stressors. It does not imply a mental illness in every case, but it does indicate that the stress exceeded the person’s usual coping abilities at that time. Examples of stressors include relationship changes (separation, divorce), loss of a job, financial difficulties, serious illness or injury, relocation, traumatic events, or major life transitions.

Risk factors that can increase the likelihood of developing an adjustment disorder include:

• Recent or multiple stressful life events happening in a short period
• History of mood or anxiety problems or other mental health conditions
• Limited social support, poor coping skills, or few effective problem-solving strategies
• Chronic medical conditions or high levels of physical pain
• Substance use that complicates mood or behavior
• Traumatic experiences earlier in life or ongoing stressors such as caregiving duties

Age, gender, and cultural background influence how symptoms are experienced and expressed, but adjustment disorder can affect anyone. Early recognition of risk factors can guide timely help and reduce the risk of symptom progression.

How it’s diagnosed by professionals

A qualified clinician—such as a psychiatrist, psychologist, licensed clinical social worker, or primary care provider—assesses adjustment disorder using clinical interview and diagnostic criteria. The process typically includes:

• Detailed history of the stressor(s) and symptom onset
• Assessment of distress and impairment in daily life (work, school, relationships)
• Mental status examination to evaluate mood, thinking patterns, and behavior
• Rule-out of other mental health disorders that could explain the symptoms (for example, major depressive disorder, generalized anxiety disorder, PTSD, or bipolar disorder)
• Consideration of medical conditions or substance use that could mimic mood or anxiety symptoms
• Use of structured interviews or screening tools as needed to inform diagnosis

Because adjustment disorder is time-limited by the stressor, clinicians also assess whether the stressor has terminated or whether ongoing stress is likely. A careful differential diagnosis helps guide appropriate treatment planning.

Treatment approaches and options

Evidence-based care for adjustment disorder with anxiety and depressed mood typically combines psychotherapy, lifestyle adjustments, and, when indicated, medication. Treatment is usually short-term and tailored to the individual’s goals, strengths, and life context.

Psychotherapy

• Cognitive-behavioral therapy (CBT): helps identify and modify unhelpful thinking patterns and develop practical coping skills, problem-solving, and stress management strategies.
• Interpersonal therapy (IPT): focuses on relationships and role changes, such as work or family dynamics, that may contribute to symptoms.
• Short-term psychodynamic or supportive therapy: provides a safe space to explore emotions related to the stressor and build resilience.
• Group or family therapy: can offer social support, reduce isolation, and improve communication.

Medications

• Antidepressants (such as SSRIs or SNRIs) may be used to treat co-occurring or persistent depressive or anxious symptoms.
• Short-term use of anxiolytics (e.g., benzodiazepines) may be considered for acute anxiety, but they are generally avoided as a long-term solution due to dependence risks.
• Medication decisions are individualized and typically revisited as therapy progresses.

Self-management and lifestyle

• Regular sleep, physical activity, and a balanced diet
• Mindfulness, relaxation techniques, and stress-reduction practices
• Structured routines, goal-setting, and time management
• Healthy social connections and seeking support from trusted people
• Problem-solving strategies to address stressors where possible

Practical and supportive care

• Work or school accommodations when needed (flexible deadlines, reduced workload)
• Care planning with family or caregivers if appropriate
• Monitoring for safety concerns and escalation if symptoms worsen or suicidal thoughts emerge

Prognosis improves with timely treatment and active coping. The goal is not to eliminate stress entirely but to reduce its impact on daily life and restore a sense of control and functioning.

Prognosis and living with the condition

Most people with adjustment disorder recover within several months after the stressor has subsided or with effective treatment. Early engagement in psychotherapy and support networks often leads to faster improvement and fewer lingering symptoms. If the stressor is ongoing (for example, continued job instability or ongoing caregiving demands), symptoms may persist longer, but treatment can still help reduce distress and improve functioning.

Key aspects of living well with adjustment disorder include recognizing early warning signs, maintaining routines, asking for support when needed, and using skills learned in therapy. People may experience relapses if new stressors arise, so ongoing access to coping strategies and support can be valuable even after initial symptoms improve. Recovery is highly individual, and small steps—such as a better night’s sleep or a single productive day at work—are meaningful indicators of progress.

Engaging with trusted clinicians, maintaining social connections, and practicing self-care are important parts of long-term resilience. If symptoms intensify or persist beyond a few months, or if thoughts of self-harm appear, seeking urgent professional help is essential.

Support resources

Helpful institutions and organizations offer education, guidance, and access to care. The following resources provide reliable information and can connect you with local services. Open links in a new tab to explore at your own pace.

• Mayo Clinic — Adjustment disorder: Symptoms and causes
• National Institute of Mental Health (NIMH) — Adjustment disorders
• MedlinePlus — Adjustment disorder
• American Psychological Association — Adjustment disorder
• NAMI — Adjustment Disorder
• Mental Health America — Adjustment Disorder
• 988 Lifeline — National Suicide & Crisis Lifeline

If you are struggling, consider reaching out to a local mental health professional or your primary care provider. In crisis or with immediate danger, contact emergency services in your area.

For ongoing support, a combination of therapy, social support, and, when appropriate, medication can help many people regain balance and functioning. You deserve care that respects your experience and promotes your wellbeing.