Adjustment Disorder (AD) And Addiction

Medically Reviewed by Johnelle Smith, M.D on July 5, 2021

Adjustment disorder (AD) typically occurs as a reaction to personal or familiar stressors that can result in symptoms including anxiety, depression, and disturbed conduct. People with AD may use drugs or alcohol as a way to cope with life changes or a way to disobey rules or societal standards.

Co-Occurring Adjustment Disorder And Addiction

When sudden life changes or difficult situations occur, most people experience some form of emotional response.

But when the emotional response is strong, prolonged, and disproportionate, some people may seek a professional diagnosis — known as adjustment disorder (AD).

People with symptoms of adjustment disorder may be more likely to use drugs or alcohol to mask or cope with strong feelings of anxiety or depression. Other people might use substances as a method of rebellion against family or societal rules.

Regardless of the reason for substance use, properly treating addiction with an understanding of the co-occurring adjustment disorder can provide a more positive outcome.

Learn more about co-occurring addiction and stress/trauma-related disorders

What Is Adjustment Disorder?

An adjustment disorder is considered a behavioral or emotional reaction to a stressful life event or change. It is commonly diagnosed in children or adolescents but can also occur in adults.

The criteria for adjustment disorder indicate the need for a person’s reaction to being high-intensity, beyond-normal grief reaction where no other co-occurring mental illnesses are present.

People that react to a stressor in an excessive or otherwise unhealthy way within three months of its occurrence may be diagnosed with adjustment disorder.

It typically results in some combination of anxiety, depression, and “acting out”.

Signs Of Adjustment Disorder

Signs of an adjustment disorder vary by person but have many of the same traits.

Signs of adjustment disorder include:

  • Depressed mood:
    • general sadness/tearfulness
    • hopeless feelings
    • lack of interest in normal activities
  • Anxiety:
    • separation anxiety
    • worry
    • nervousness/jitters
  • Disturbed conduct:
    • breaking rules
    • fighting
    • recklessness
    • disobeying rules
    • reckless behavior
    • social withdrawal

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Signs Of Drug Or Alcohol Abuse

Drug and alcohol abuse commonly occurs in people with adjustment disorder. Many times, substance use in people with AD occurs as a form of self-medication or as a method of rebellion.

And though AD causes symptoms resulting in changed behavior, co-occurring addiction and substance abuse can result in additional, notable changes.

Drug and alcohol abuse can lead to both large and small behavioral and physical changes. Some changes may be ignored or confused for symptoms of a mental health condition.

Some substances can affect energy levels (increased or decreased energy) and can impact cognitive ability.

Similarly, changes in appearance like sudden weight loss or lack of care for appearance when observed with other changes may indicate a substance use disorder.

Signs of drug or alcohol abuse may include:

  • strange behavior
  • sudden mood changes
  • being secretive or hiding evidence of substance use
  • detaching from family, friends, and preferred activities
  • engaging in abnormally risky behavior
  • taking on atypical or needless risks
  • noticeable alcohol or drug use for everyday function
  • big changes in hygiene or appearance

What Causes Co-Occurring Addiction And Adjustment Disorder?

An adjustment disorder may happen after a number of major life changes, like:

  • personal or family illness
  • moving
  • loss of money or job
  • loss of friend or family
  • major trauma
  • relationship struggles
  • conflict (in kids/teens)
  • problems with sexuality/puberty (in kids/teens)
  • school issues (in kids/teens)

For people without diagnosed AD, a normal stress response may elicit a desire to use drugs or alcohol to escape or cope with reality.

When a prolonged, non-standard emotional response occurs, a person may use drugs or alcohol to rebel against authority or to temper feelings of anxiety or depression.

How Common Is Substance Abuse And Adjustment Disorder?

Co-occurring substance abuse with an adjustment disorder is common. Other precipitating factors include decreased school or work performance, suicidal ideation, and relationship problems.

Risk Factors Of Addiction And Adjustment Disorder

Many of the same factors that may cause adjustment disorder are risk factors for drug and alcohol use.

Adjustment disorder is equally diagnosed in both men and women during childhood and adolescent years. However, women are diagnosed at two times the rate of men as adults.

People that are hospitalized for any reason experience adjustment disorder at a 12% rate. Adjustment disorder normally occurs in between 2% and 8% of people.

What Are The Most Effective Treatments?

Both addiction and adjustment disorder can be treated with group, family, and individual therapies. Symptoms of withdrawal during detox can be mitigated with therapeutic medications.

Group And Individual Therapy

Peer Group Therapy: For some people, sharing with peers in a safe environment can promote positive social skills and communication.

Family Therapy: When trauma occurs because of family or involves family dynamics, recovery from both addiction and AD may be helped by addressing issues in the family system.

Family therapy can build communication skills, improve interactions, and create a positive environment for continued healing.

Cognitive-Behavioral Therapy (CBT): With the assistance of a therapist, a person with co-occurring AD and addiction can learn how to control impulses, address stressors, and think about feelings in a constructive way.

Understanding the reasoning behind old thought patterns can help people develop skills to succeed without drugs or alcohol. These tools can also help a person recognize and re-frame stressors that lead to AD.

Prescription Medications

If drug or alcohol detox is warranted, an inpatient rehab facility may provide medications to ease symptoms of withdrawal. Some medications may also ease anxiety related to symptoms of adjustment disorder.

There are no “one-size fits all” detox regimen, but some programs may include prescription drugs, such as:

  • buprenorphine
  • methadone
  • benzodiazepines (as appropriate)
  • naltrexone
  • SSRI antidepressants (for symptoms of AD)

Finding Dual Diagnosis Treatment For Adjustment Disorder And Addiction

An alcohol or drug addiction that co-occurs with adjustment disorder can be treated in an inpatient or outpatient setting, depending on the person’s needs.

If you or a loved one has been using substances following a major life change, help is available.

Call our treatment specialists to learn about the best dual diagnosis treatment facility and the range of treatment options available for your needs. Recovery and change are possible. Take the first step today.

This page does not provide medical advice. See more

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Medically Reviewed by
Johnelle Smith, M.D on July 5, 2021
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