How to Differentiate Normal Stress and Adjustment Syndrome

By: Michael Lam, MD, MPH

How Do I Know If I Have Adjustment Syndrome?

Adjustment syndrome means inability to adjustStress is normal. Every person in the world will be stressed in some way or the other. It has no discrimination among people of different: age, gender, race, or the country one is in. The only distinction would be the extent to which one is stressed. So, at what point is stress considered adjustment syndrome?

You can be stressed physically, mentally, psychologically, and neurally as well. Whenever you would be subjected to a situation that demands more than what you can physically or mentally bear, you would be under stress. Such stress is normal and how you deal with it would determine whether or not you have adjustment disorder.

In medical jargon, stress is often related to the high levels of cortisol secretion. Cortisol is popularly known as the stress hormone. Research is still underway to ascertain if it is stress that causes the higher secretion of the hormone or if it is the hormone that causes stress. In most studies published to date, it is stress that triggers the secretion of the hormones and not vice versa. This clearly proves that stress is a reaction to any situation that turns demanding or an individual is unable to cope with.

Trouble adjusting to stress is the disorder that doctors refer to as adjustment disorder. People have different ways of handling stress and they also react differently. How you deal with stress will vary from how a friend would. A person suffering from anxiety, getting impatient, and having mild mood swings during stress is normal. It is when these reactions become sporadic and severe that the situation can become troublesome and indicative of adjustment disorder.

There are people who cannot deal with stress. They take to addictions including: excessive alcohol consumption and incessant smoking to start off, but they can give way for further adventures. Those who cannot adjust to stress will have emotional difficulties in relating to others and would not be engrossed to most familial or friendly ties. It is common for someone who is too stressed to have neural problems when one cannot adjust. Headaches, indigestion, lack of proper sleep, and sense of fatigue are normal reactions to stress, but when these symptoms become severe, regular, and show no signs of receding, it can be the first signs of adjustment disorder.

Stress is Not Permanent

Stress is a temporary state and when the stressing catalyst or situation is not existent stress will subside but adjustment disorder would linger on.

Stress in any form can have an array of negative health consequences, so pinpointing its source is an important first step in the healing process. Regardless of the origin, stress causes increased cortisol levels. Cortisol is regulated through the hypothalamus-pituitary-adrenal (HPA) axis, which is in charge of the adrenal glands. The HPA axis is only part of a complex and harmonizing entity called the NeuroEndoMetabolic (NEM) system, which is responsible for keeping stress from at bay in the body.

When stress becomes too much or too overwhelming for the body, the NEM – which encompasses all organs and organ systems – can go awry. Initial disruption through this system through this adrenal and HPA axis connection can set off a disruption of hormone levels by way of adrenal glands, thyroid and more that eventually leads to irregularity in reproductive, metabolic, neuro-affective, inflammatory, and detoxification responses. The body – without intervention – could eventually preserve only the functions needed for survival, which can be seen in the last phases of adrenal fatigue.

Adjustment syndrome and stressDetermining whether or not you suffer from adjustment syndrome is extremely important to your journey in AFS recovery. Removal of stressors is the most important aspect of AFS healing, but this process may look differently for someone that is continually stressed or has symptoms of stress – even when the source is mitigated. The presence of adjustment syndrome could cause great variation in treatment methods for those also suffering from adrenal fatigue. Utilizing tools such as the adrenal diet, proper sleep, along with medically guided medication and exercise can help to heal not only AFS but help alleviate stress to the body. Understanding normal signs of stress as opposed to unyielding and severe signs of stress is important to the proper function of both the adrenals and the NEM system.

Dealing with high stress levels is an adjustment skill, without it Adjustment Syndrome may occur

© Copyright 2013 Michael Lam, M.D. All Rights Reserved.
5 - "Dr Lam, I am amazed and shocked"
Dr Lam,
I am amazed and shocked to be just now learning of this at the age of 38. Finally my symptoms are explained and I’m not just told I’m over reacting. I knew this wasn’t normal. Thank you for being an advocate for many suffering from this invisible illness!
God Bless you and your family!


  • merek says:

    I find imformation about treatments for adjustment disorder on What do you think about this site? Advise me how can I fight with adjustment disorder with depressed mood. Thanks.

  • Leah says:

    How can “adjustment disorder” as indicated in the article, be remedied so that it won’t linger on?

    • Dr.Lam says:

      Adjustment disorder describe the body’s response to stress. To recover, you ultimate need to solve the root problem. So find out what the stressors are and remove. That is easier said than done, especially if there are long term relationship and financial issues that cannot be resolved quickly. At the meantime, learning to let go and accept the reality is often helpful . Seeking the help of a mental health professional may also be very valuable to give you more insight on the source of the stress and better help you to deal with it. Because stress ultimately affect the adrenal glands, learn to support optimum adrenal function with diet is also good. Read Adrenal Fatigue Syndrome for more information.

      Dr Lam.