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Adjustment disorder with depressed mood is a diagnosis to describe what many people would call situational depression — a temporary depression that comes about because of a particular stressor. What do you need to know about it?

Are you feeling really down — to the point that your daily functioning is affected — because some very stressful things have been going on in your life recently? If your mood has suffered a big blow, you may be finding yourself wondering whether you could be clinically depressed. Though depression can strike in people who don't have any "objective reason" to be depressed, it can also indeed set in after a specific trigger or multiple triggers. 

People in stressful circumstances may, however, instead be diagnosed with something called adjustment disorder. This diagnosis has several possible "add-on" features, of which "with depressed mood" is one.

Adjustment disorder with depressed mood is a lot like what's called situational depression in layman's terms; a kind of depression that is caused by something stressful and painful within your environment. 

While the link between major depressive disorder, the label that will typically come to mind when you think about clinical depression, and adjustment disorder with depressed mood is obvious in that these diagnoses both come with a (you guessed it!) depressed mood, there are some key differences as well. This is why it sits in the "trauma and stressor-related disorders" section of the DSM-5, the Diagnostic and Statistical Manual of Mental Disorders, rather than being found in the chapter on depressive disorders. 

What do you need to know about adjustment disorder with depressed mood?

Could YOU have adjustment disorder with depressed mood?

The following descriptions will apply to people who are diagnosed with adjustment disorder, or would be if they sought medical attention:

  • You're suffering from what the DSM-5 calls "emotional or behavioral symptoms" as a result of a clear stressor in your life, and these symptoms show up within three month of the triggers. More about what these symptoms can entail if you have adjustment disorder with depressed mood in a bit. 
  • You're either more distressed by the circumstances than would be deemed typical in your cultural environment or find your symptoms really impact your daily functioning, at work or in your social life, for instance. You can also meet both these criteria at once. 
  • The symptoms you're experiencing as the result of the stressor(s) in your life can't better be explained by another mental disorder, and didn't come about because the stress made the symptoms of a mental disorder you were already diagnosed with worse. 
  • Whoever is responsible for making the diagnosis determines that your symptoms are more than "normal bereavement", which is fairly subjective because people grieve in different ways depending on their individual backgrounds — things like gender, culture, and personality all impact the way in which a person grieves. 
  • Finally, your symptoms should come to an end within six months of the stressor or its consequences disappearing from your life. This is another aspect of this particular diagnosis that some people will have trouble with — it's hard to define if and when the "consequences" of far-reaching life changes like job loss, divorce, and the death of a loved one come to an end. 
These are the basic diagnostic criteria for adjustment disorder, but there's more to the diagnosis, as several subtypes are "available". If you have adjustment disorder with the specifier "depressed mood", you'll experience symptoms a lot like depression; things like feeling down, low, empty, tearful, sad, and depressed. It's called adjustment disorder because you are, essentially, finding it hard to adjust to a new situation. 

What kinds of stressors can trigger adjustment disorder with depressed mood?

Almost anything recognized as being stressful and painful for human beings can lead to adjustment disorder. The DSM-5 points out that:

  • The stressor can be a single event. They offer the end of a romantic relationship as an example, but others that come to mind would include suffering a miscarriage, being laid off, or having your home foreclosed.
  • There can also be more than one stressor — a combination of being really busy at work and learning your child has a chronic medical condition, to name one example. 
  • Stressors can be recurrent, such as going through a rough patch in your relationship or marriage, dealing with the management of a health condition, or coming to terms with others' reactions to coming out as gay, for instance. 
  • The stressor may be something that is stressful but common in people's lives — things like leaving home for college or getting married can trigger adjustment disorder. This also includes the death of a loved one, if the symptoms go beyond what is considered normal grief. 
  • Events that multiple people experience at once can lead to adjustment disorder. In this case, the DSM-5 uses natural disasters as one example.

How is adjustment disorder diagnosed?

Your diagnosing healthcare provider will look at other possible diagnoses as well after hearing what kinds of symptoms you're looking at. Post-traumatic stress disorder, major depressive disorder, acute stress disorder, and other mental health diagnoses will all be considered. In addition, your healthcare provider will look at the possibility that what you're feeling now is considered totally normal in your circumstances, and you therefore don't need any diagnosis (something the DSM-5 calls "normative stress reactions"). 

Keep in mind that anyone who's going through a rough patch in life — whether or not any diagnosis can be attached to that — may benefit from the very thing your doctor is going to encourage you to participate in if you're diagnosed with adjustment disorder. That's talk therapy, of course. People with adjustment disorder may also be offered antidepressants to help them recover from their symptoms, however, something that wouldn't help you if you were dealing with normal stress or pain. 

In conclusion

"Adjustment disorder with depressed mood" is a diagnosis that we could poke holes in because of the subjective nature of its diagnostic criteria. It's connected to depression in that it features many similar symptoms, and is very close to what most people would call "situational depression". The diagnosis is there for people who are feeling depressed after experiencing identifiable triggers — depressed for a reason, if you like — but who are having more difficulty coping than would be expected in their situation. It signifies, essentially, that you may need some extra help adjusting. 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  • Photo courtesy of SteadyHealth.com

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