HomeBlogMental Health GuidesAcute Stress Disorder vs Adjustment Disorder – What’s the Distinction?

Acute Stress Disorder vs Adjustment Disorder – What’s the Distinction?

Mental health disorders come in several varieties. Many have overlapping symptoms, and it can be hard to differentiate which condition or treatment is ideal. This article will focus on reviewing the distinctions and similarities between acute stress disorder vs. adjustment disorder.

Stress and mental health

Everyone struggles with stress. It is a natural, biological defense mechanism that helps us stay safe.

Stress is what gave our ancestors pause when they saw something large in the bushes, waiting to see if it was a rock or a lion. 

Historically, that stress is what helped them stay alive. 

Today that same mechanism of action is what drives you to pay attention while you drive so you don’t hit something or get out of bed to go to work so you don’t get fired. But the biological action of stress is now often associated with unimportant things, not life-saving things. This means that people are more likely to struggle with the ill effects of stress like high adrenaline, poor immune function, and mental health struggles. 

When this happens, stress-related disorders can arise. 

acute stress disorder vs adjustment disorder

Defining acute stress disorder vs adjustment disorder

Acute stress disorder first appeared in the 4th edition of the DSM. The idea behind the definition was to help predict which individuals would start to develop things like PTSD After experiencing trauma.

By addressing symptoms and onset, incorporating acute stress disorder is designed to provide appropriate treatment much sooner.

Adjustment disorder is categorized as a trauma-and-stressor-related disorder. It is defined as a disorder brought about by exposure to a traumatic or stressful event. The most identifiable aspect is the presence of behavioral or emotional symptoms in direct response to a specific stressor. Around 20% of individuals who seek mental health treatment in the US have an adjustment disorder. 

Onset and duration of symptoms with acute stress disorder vs adjustment disorder

For acute stress disorder, disturbances have to last at least two days immediately after a trauma but no more than four weeks. Similarly, the symptoms HAVE to occur within four weeks of the traumatic event taking place.

For adjustment disorder, many of the stressors or triggers that cause adjustment disorders accompany specific developmental stages in life, such as:

  • Going to school or moving to a new school
  • Leaving home for the first time
  • Moving back in with parents
  • Getting married
  • Having children
  • Changing jobs
  • Problems at work
  • Retirement

The symptoms must manifest within three months of the identifiable stressor. This means that the onset of symptoms will start around the same time as those specific changes, but once the stressor is terminated, the symptoms cannot persist for more than six months.

Types of stressors and triggers for acute stress vs adjustment disorder

There are several types of stressors and triggers for acute stress disorder that have to do with exposure to a traumatic event. The traumatic event in question can include things like:

  • Being in a car accident
  • Witnessing violence
  • Being the victim of violence or attacks
  • Being in a natural disaster
  • Domestic abuse
  • War or torture

Individuals can be diagnosed with acute stress disorder even if they did not directly experience the trauma themselves but rather had a close family member who experienced a traumatic event. 

Stressors for adjustment disorder can be recurrent things like seasonal work issues that lead to financial strain, but they can also be continuous problems like struggling with a chronic illness that will eventually lead to disability or living in a poor neighborhood riddled with crime. Stressors can affect individuals, such as interpersonal problems in a marriage, or they can be things that affect an entire family, like low income, or even the larger community, like a natural disaster.

Symptomatology and how symptoms manifest in acute stress disorder and adjustment disorder

In order to be diagnosed with acute stress disorder, an individual needs to have, first, experienced a traumatic event and, second, have at least one symptom of re-experiencing that traumatic event. The possible symptoms of re-experiencing include the following:

  1. Recurring thoughts
  2. Images
  3. Nightmares
  4. Flashbacks
  5. Intense emotional distress when reminded of the trauma or triggered

An individual must also display avoidance of any reminders of the traumatic event or avoidance of thoughts related to the traumatic event.  

With acute stress disorder, there must also be symptoms of increased anxiety or arousal, including:

  1. Sleep issues
  2. Irritability
  3. Poor concentration
  4. Hypervigilance 
  5. Being startled easily

In order to be diagnosed with acute stress disorder, individuals must experience symptoms that are severe enough to interfere with daily function or cause significant distress. Acute stress disorder also requires that the person have three of the five dissociative symptoms during the traumatic event or immediately after, including:

  1. Numbing/detachment
  2. Reduced awareness of one’s surroundings
  3. Derealization
  4. Depersonalization
  5. Dissociative amnesia 

In order to be diagnosed with an adjustment disorder, an individual must display emotional and behavioral symptoms in response to clearly identifiable stress or stressors. 

Symptoms must cause marked distress that is disproportionate to the intensity or severity of the trigger or stressor. It must also cause significant impairment in daily life occupational or social function.

Symptoms can include:

  • Depressed mood, including feelings of hopelessness, tearfulness, and low mood.
  • Anxiety, including feelings of dominant nervousness, separation anxiety, worry, or jitteriness. 
acute stress disorder treatment

Treatment approaches and prognosis for adjustment disorder vs acute stress disorder

The most common treatment for acute stress disorder is a trauma-focused form of CBT. This type of treatment generally involves some type of exposure therapy to change the way in which individuals have stored traumatic memories and the way those memories excite fear. This type of treatment helps to disrupt any cognitive distortions and provides better management of symptoms. Coping skills and emotional regulation can be complementary, holistic treatments as well.

The sooner an individual gets treatment for acute stress disorder, the more likely they are to prevent the acute stress disorder from becoming PTSD.  

Treatment for adjustment disorder is very similar to acute stress disorder and centers on cognitive behavioral therapy. But it can also extend to family therapy if the entire family is affected by the behavioral and emotional symptoms. Therapy can help provide:

  • Impulse control
  • Stress management skills
  • Anger management skills
  • Communication skills
  • Problem-solving skills
  • Coping skills
  • Emotional regulation skills

Individuals who participate in therapy and build things like age-appropriate coping skills can develop the resilience they need to reduce the impact of any new stressors or triggers moving forward and will have a positive prognosis.

Acute stress vs adjustment disorder in daily life

When struggling with acute stress vs adjustment disorder, the impact on daily life is still something that has to be managed. If you are dealing with either disorder, consider these tips:

  1. First, be honest with your friends and family. They can attend support groups or do research to learn how best to support you in your time of need. 
  2. Second, practice self-care. No matter the treatment you get, self-care is essential to building coping skills and emotional regulation skills that can help you manage stress. 

Summing Up

Overall, with acute stress disorder vs adjustment disorder, you struggle with similar symptoms, but differences in stressors, onset, and treatment. If you are struggling with either condition, it’s imperative that you seek emotional help if needed. In some cases, the symptoms might go away on their own once the source of stress is resolved, but if they linger, don’t be afraid to reach out for help.

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