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? This is a particularly important question if you suffer from Adrenal Fatigue Syndrome (AFS), which is strongly linked to stress. If you struggle to cope with stress, it may make you more prone to AFS, and it could also worsen your AFS symptoms.

Stress and 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.If you experience this condition, it will affect your everyday life in a variety of ways. And it may also cause or exacerbate your AFS.

What is AFS?

AFS is a common disorder that’s caused by ongoing stress that fatigues the systems in the body that are designed to respond to stress. When you’re under stress, the NeuroEndoMetabolic (NEM) Stress Response activates. This system activates other responses that protect your body from stress and prepare it to react in case of danger.

One of the first reactions activated by the NEM stress response is the release of cortisol. During times of stress, the adrenal glands secrete more cortisol than usual, which wakes up the body and puts it into a state of high alert. And when the stress has passed, the adrenals put out less cortisol and the body can rest. However, because modern life is full of chronic and ongoing sources of stress, this system can start to break down. The adrenal glands become fatigued, which sets off a vicious circle of reactions throughout the body’s circuits.

For most people, this results in a confusion of seemingly unrelated symptoms and problems. One of the most troubling and difficult to correct ways that it affects the body has to do with the body’s balance of neurotransmitters and the neuroaffect circuit. When this circuit becomes affected by AFS it can cause a range of problems. It can also have an impact on how you respond to stress and cause or exacerbate adjustment syndrome.

The Neuroaffect Circuit and AFS

Neurotransmitters are some of the most essential and often forgotten substances in the human body. They regulate, control, and maintain a lot of the body’s essential functions, and when they become unbalanced, it can cause a range of problems. Unfortunately, neurotransmitter imbalances are common. They occur when the neuroaffect circuit of the body becomes dysfunctional because of factors such as stress, poor diet, toxins, genetics, or the advanced stages of AFS. When these imbalances occur, they can result in a range of problems such as general fatigue, memory problems, addictions, Irritable Bowel Syndrome (IBS), and mood disorders.

Stress can be a key cause of neuroaffect circuit dysfunction and neurotransmitter imbalances. And when this occurs, the symptoms will be very similar to those suffered by people who experience adjustment syndrome. This suggests that some of the difficulties suffered by people with adjustment syndrome such as addictions, fatigue, and emotional problems, could be caused by neurotransmitter imbalances. There is no real way to tell if there is a cause and effect relationship here.

However, even if these are two separate problems, you still need to be aware of the consequences of the neurotransmitter imbalances caused by AFS when you have adjustment syndrome. Imbalances in the neuroaffect circuit will worsen your symptoms and make it more difficult for you to cope with stress. And this, in turn, will exacerbate your AFS, causing even more stress. If you find yourself in this vicious circle, it will hamper your AFS recovery and seriously affect the quality of your life and your overall health. That’s why it’s so important that you find healthy ways to cope with stress and support your body during such a stressful period.

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.

© Copyright 2013 Michael Lam, M.D. All Rights Reserved.

Dr. Lam’s Key Question

Stress is a normal part of life, yet some people seem to struggle with it more than others. If you find that any level of stress causes negative consequences, then you may have adjustment syndrome. And this could have consequences for your overall health.

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