Depression Articles

Adjustment Disorder with Depressed Mood

This is also called a "reactive depression." The diagnosis of an adjustment disorder implies that specific psychological symptoms have developed in response to a specific and identifiable psychosocial stressor. However, this diagnostic group (adjustment disorders) is a "last resort" category. If the symptom picture suggests that the person meets the diagnostic criteria for another psychological disorder, than this diagnosis is not used. For example, if a person experiences a trauma, and develops the symptoms of a major depression, then the diagnosis of adjustment disorder is not used, even though the depression developed in response to a psychosocial stressor. So, adjustment disorder with depression is used to categorize mild to moderate depression, following a stressful event. 

Also, the depressive symptoms related to an adjustment disorder should be treated and dissipate within six months following the end of the stress that produced the reaction. If the symptoms last longer, then the above diagnosis of Depression, not otherwise specified, is probably more appropriate. There is an exception to this rule, as some stressors continue over a long period of time, rather than occurring as a single event. For example, if a person is harassed on the job, that can continue for months. In such a case, the depression may not be severe enough for a diagnosis of major depression, but it would continue for more than six months. But, since the stress is continuing, then the adjustment disorder diagnosis could still be used. 

The symptom picture is similar to other depressive disorders, and the recommended treatment is still cognitive-behavioral therapy and/or interpersonal therapy. However, because of the relationship between the symptoms and a specific stressor, there is more emphasis put on resolving the problem that created the stress. This may involve making concrete changes in the way the person manages his/her life, and may require specific action and decision making. (e.g. If job stress is resulting in depression, the person may need to decide whether changing jobs is the most appropriate solution.) Often people become depressed in reaction to psychosocial stressors when they don't believe a solution exists to their problem. In such cases, helping the person develop a reasonable solution is a key part of the treatment process.