Adjustment Disorder vs. Depression: What Differences to Look for

Adjustment Disorder vs Depression

Everyone faces a major life event at some point, whether it’s moving to a different state, starting a new job or losing a loved one. It’s normal to feel stressed or upset about life changes, but experiencing extreme stress that interferes with your everyday routine may indicate a larger problem. An adjustment disorder is a stress-related condition that can cause a variety of symptoms similar to clinical depression.

While the two conditions share overlapping symptoms, they also differ in numerous ways. If you or someone you know is experiencing more stress than normal regarding a life change, learn more about the differences between adjustment disorder and depression to ensure you get proper help.

What Is Adjustment Disorder?

Adjustment disorder is used to describe individuals having a tough time coping with a significant life change that causes stress. While many situations, including work problems, an illness, divorce or the death of a close family member, can cause stress, most people adjust to changes within a few months. An adjustment disorder occurs when a person experiences more stress than expected in response to an event, resulting in significant issues at work, at school or in relationships.

An adjustment disorder can affect how you think and feel about yourself or the world. It can also cause feelings of anxiety or depression that may affect your actions or behavior. An adjustment disorder with anxiety or depressive symptoms can cause:

  • Sadness, hopelessness or not feeling like yourself
  • Trouble sleeping
  • Reduced appetite
  • Frequent crying
  • Difficulty concentrating
  • Withdrawal or social isolation
  • Feeling overwhelmed or nervous
  • Difficulty functioning in daily activities
  • Avoiding important tasks, such as paying bills or attending work
  • Suicidal thoughts or behavior

Symptoms usually start within 3 months of a stressful event and end about 6 months after. However, a chronic adjustment disorder can last for more than 6 months, especially if the stressor is ongoing, such as unstable housing or unemployment.

What Is Major Depression?

Depression is a mood disorder that causes persistent feelings of sadness and loss of interest in activities you may otherwise enjoy. Also referred to as clinical depression or major depressive disorder (MDD), this condition can affect how you think, feel and behave, causing various emotional and physical problems. According to the National Institute of Mental Health, major depression is one of the most common mental disorders in the United States. In 2020, an estimated 21 million U.S. adults reported experiencing at least one major depressive episode.

While depression may occur only once in a lifetime, it’s common for people to have multiple episodes over time. During a depressive episode, you may experience various symptoms nearly every day, such as:

  • Feelings of sadness, hopelessness or emptiness
  • Loss of interest in most or all pleasurable activities, including hobbies, sports or sex
  • Trouble sleeping or oversleeping
  • Agitation or anxiety
  • Reduced appetite and weight loss
  • Angry outbursts or irritability over small matters
  • Slowed thinking or movement
  • Feelings of guilt or worthlessness
  • Frequent or recurrent suicidal thoughts

Symptoms are usually severe enough to disrupt daily activities, such as work, school, social activities or relationships. It’s common for people with MDD to feel constantly miserable or unhappy without knowing why.

Differences Between Adjustment Disorder vs. MDD

Adjustment disorders and MDD often share similar symptoms. In fact, adjustment disorders share overlapping symptoms with and are commonly mistaken for several other conditions, including bipolar disorder, acute stress disorder, post-traumatic stress disorder and personality disorders. However, there are key differences between adjustment disorder and MDD.


An adjustment disorder can usually be tied to a specific life event, such as a traumatic experience, divorce or job loss. MDD usually can’t be attributed to a specific event and is caused by a variety of genetic, biological, environmental and psychological factors. Many people with depression start to develop symptoms without fully understanding why.

Duration of Symptoms

An adjustment disorder has similar symptoms to MDD, but these symptoms may be more intense for those with depression. Adjustment disorders are typically resolved within 6 months. A major depressive episode usually lasts for about 2 weeks. However, an episode can progress into a long-term major depressive disorder with severe symptoms that won’t go away without professional treatment.

Diagnostic Criteria

The Diagnostic and Statistical Manual of Mental Disorders (DSM) also lists different criteria for each condition. To be diagnosed with an adjustment disorder, an individual must experience symptoms within 3 months of a stressful situation that cause significant social or occupational impairment. For an MDD diagnosis, at least five of the listed symptoms must be present for at least a 2-week period:

  • Depressed mood and energy
  • Diminished interest or pleasure in activities
  • Substantial changes in appetite
  • Significant or unintentional weight gain or loss
  • Notable changes in sleeping patterns
  • Feeling agitated or lethargic during everyday activities
  • Overwhelming guilt or persistent feelings of worthlessness
  • Difficulty concentrating
  • Recurrent thoughts of death or suicidal ideation

To determine what diagnosis you have, your health care provider may ask questions about your symptoms and conduct an assessment. You may also be asked to fill out a questionnaire regarding your symptoms, feelings, thoughts and behavior pattern. Once a diagnosis is complete, you can consider treatment options.

Treatment Strategies

Despite their differences, adjustment disorders and depression can cause severe symptoms that affect your thoughts, feelings and daily life. Both are usually treatable with therapy or medication or a combination of the two. Cognitive behavioral therapy (CBT) is a type of psychotherapy that involves speaking to a therapist in a structured environment. The goal is to identify and challenge negative thoughts, so you can develop healthier ways of viewing and responding to situations.

Antidepressants may also be prescribed to minimize symptoms. Selective serotonin reuptake inhibitors (SSRIs), such as Lexapro, Prozac or Zoloft, are the most commonly prescribed antidepressants because they’re generally considered safer and cause fewer side effects. Benzodiazepines, such as Xanax or Valium, may be another option to target specific anxiety-inducing situations, especially with an adjustment disorder.

Help Is Available

Living with a mental health disorder of any capacity can be difficult and adversely affect your life. If you’ve been struggling with symptoms of depression or adjustment disorder, Restore Mental Health offers various treatment options for mental disorders in a supportive environment. Contact us today to speak with an admissions counselor and take the first step toward getting the help you need.