Adjustment Disorder is one of the most dismissed mental health problems, mostly because it sounds “mild.” People hear the name and think it means you’re being dramatic about normal life stress. In real life, it can flatten people. It can turn a capable adult into someone who can’t sleep, can’t concentrate, can’t stop crying, can’t get out of bed, or can’t stop snapping at everyone around them. It can look like depression. It can look like anxiety. It can look like burnout. It can look like a person suddenly “losing it,” and then being judged for it.
The core idea is simple, something changed, and your system didn’t adapt fast enough. The problem is that modern life doesn’t leave room for slower adaptation. People are expected to keep performing at work, keep parenting, keep showing up socially, keep paying bills, keep smiling, keep responding to WhatsApps, keep being “fine.” When the mind and body are under too much pressure, they start misfiring. Sleep collapses. Appetite shifts. Motivation evaporates. The nervous system stays stuck in alarm mode. Then people reach for relief, alcohol, pills, cannabis, whatever takes the edge off quickly, and suddenly you’ve got two problems instead of one.
This is why Adjustment Disorder matters in addiction work. It’s one of the common pathways into substance use for people who weren’t “addicts” in the stereotypical sense. They were coping. Then coping turned into dependence.
What Adjustment Disorder actually is
Adjustment Disorder is a stress response that becomes excessive and disruptive after a specific life change or stressor. The stressor can be obvious and dramatic, a divorce, a death, retrenchment, financial collapse, a move to a new city, a serious illness. It can also be something people underestimate, a new job, a promotion, a new baby, kids leaving home, a relationship shift, a diagnosis, a change in living conditions, even moving back in with family as an adult.
It is not the same as “being sad.” It’s not just normal grief or normal stress, although it can overlap with both. The difference is the impact. The reaction becomes so intense or persistent that it disrupts daily functioning, relationships, work performance, and basic self-care. The person isn’t just uncomfortable. They are destabilised.
It also isn’t a personality flaw. It isn’t weakness. Some of the toughest, most capable people develop Adjustment Disorder because they kept pushing through stress until the nervous system finally said no.
The triggers people don’t take seriously
In South Africa, a lot of people live with chronic stress. Load shedding stress. Crime anxiety. Financial pressure. Family responsibilities. Long commutes. Unstable work conditions. Medical aid battles. Under-resourced schools. The baseline stress level is already high for many households. When a major change happens on top of that, it can tip someone over quickly.
Retrenchment is a classic. It’s not only losing income. It’s losing identity, structure, routine, and self-worth. Divorce is another. It’s not only heartbreak. It’s legal stress, financial stress, parenting stress, social stress, and the grief of a life you thought you’d have. Relocation can wreck people too, especially when they move for work and lose their support system, or move back home because finances force it and the family dynamics are toxic.
Even “positive” changes can trigger Adjustment Disorder. A promotion can come with pressure and imposter syndrome. Having a baby can come with sleep deprivation, identity change, and relationship strain. Buying a house can come with financial anxiety that never switches off.
When people dismiss these triggers, they miss the real point. The person is not “overreacting.” Their internal coping system is overloaded.
How it shows up
Adjustment Disorder can show up differently depending on the person, but there are common patterns. Sleep is often the first to go, either insomnia, broken sleep, early waking, or waking with panic. Concentration becomes patchy. Memory feels unreliable. The person is easily overwhelmed by small tasks that used to be simple.
Emotionally, it can look like tearfulness, irritability, anger, numbness, anxiety, and constant worry. Some people become withdrawn. Others become restless and agitated. Many develop a “short fuse,” and they start reacting to family members in ways that feel out of character.
Behaviourally, you’ll see avoidance. The person stops answering calls. They stop attending events. They procrastinate. They miss deadlines. They start calling in sick. They stop exercising. They stop cooking. They stop caring about appearance. Or they go the opposite direction and become frantic, overworking, over-controlling, compulsive, unable to relax.
Families often interpret this as selfishness or being “difficult.” Employers interpret it as poor performance. The person then feels shame, which makes symptoms worse. Shame is fuel for avoidance, and avoidance is fuel for further collapse.
Why Adjustment Disorder and addiction often hook into each other
When someone’s stress response is stuck on high, they will look for relief. Humans are wired for relief. The brain will remember anything that quickly lowers anxiety, slows thinking, or creates temporary comfort. Alcohol does that fast. Cannabis can do that fast. Benzos do that fast. Prescription painkillers can do that fast. Even stimulants can be used to push through exhaustion and emotional collapse.
At first, it can look like “a few drinks to sleep” or “a tablet to calm down.” Then tolerance builds. The person needs more to get the same relief. Then the substance starts creating its own anxiety, its own sleep problems, its own mood swings, and its own consequences. The original stressor is still there, and now the person has a dependence problem that makes everything harder.
One of the most common patterns we see is alcohol being used as self-medication after a major life change. The person isn’t drinking to party. They’re drinking to stop thinking. That can become a trap quickly, especially in a culture where heavy drinking is socially normalised and people are praised for “holding it together.”
The family role
Families often make things worse by doing one of two things. They either criticise and shame, which increases stress and avoidance, or they rescue and take over, which makes the person feel incompetent and reinforces avoidance. The better middle is calm support plus clear expectations.
Support looks like helping the person rebuild routine, encouraging professional help, reducing unnecessary conflict, and being realistic about capacity during a destabilised period. Expectations look like not allowing the person to disappear completely, not allowing substances to become the coping tool, and not accepting ongoing dysfunction as the new normal.
If substance use is becoming part of the picture, families need to stop minimising. It doesn’t matter if the person is “not like those addicts.” Patterns are patterns. If someone needs alcohol to sleep, or needs pills to face the day, the risk is real.
When to take it seriously
If you’ve had a major life stressor and your mood, sleep, relationships, and function have shifted noticeably, and it’s been weeks and it’s not improving, take it seriously. If you’re using alcohol or pills more often to cope, take it seriously. If your family is walking on eggshells around you or you’re starting to withdraw from everything, take it seriously.
Adjustment Disorder is not a label to be embarrassed about. It’s a sign that something in your life shifted and your system needs support to stabilise. Ignoring it doesn’t make you strong. It usually just gives the problem time to deepen.
