The main differences between depression and adjustment disorder lie in the clarity of the cause and the duration of the symptoms.
- Adjustment Disorder: This is a temporary mental and physical distress triggered by a specific stressor (e.g., relationship issues at work or school, job transfers, moving). A key characteristic is that symptoms tend to improve when the person is removed from the stressful situation. The symptoms usually appear within three months of exposure to the stressor and often disappear within six months after the stressor is gone.
- Depression: This is a mental illness that can develop even without a clear stressful event. It is thought to be related to functional changes in the brain, and its symptoms persist for an extended period (more than two weeks), regardless of environmental changes.
Similarities and Differences in Symptoms
Both adjustment disorder and depression can present with similar symptoms, such as a depressed mood, loss of motivation, insomnia, and loss of appetite. However, symptoms of adjustment disorder tend to lessen or disappear when the person is away from the source of stress, whereas symptoms of depression persist regardless of the stressor.
| Item | Depression | Adjustment Disorder |
| Cause | Often no specific, clear stressor. Thought to be related to functional changes in the brain. | A clear stressor exists (e.g., relationships, work, environmental changes). |
| Symptom Onset | Symptoms often emerge gradually, unrelated to a specific stressor. | Symptoms appear within three months of exposure to the stressor. |
| Symptom Characteristics | Depressed mood, loss of interest/pleasure, and lack of motivation persist for a long time (more than two weeks). Symptoms are not easily improved by leaving the source of stress. | Appears as an excessive reaction to stress, including depressed mood, anxiety, and physical symptoms. Symptoms tend to improve when away from the source of stress. |
| Symptom Duration | Tends to be long-lasting. Can continue for months to years without proper treatment. | Symptoms often disappear within six months after the stressor is gone. |
| Treatment | Primarily rest, medication (antidepressants), and psychotherapy (e.g., cognitive-behavioral therapy). | Primarily rest and environmental adjustment. Medication and psychotherapy are used as needed. |
| Diagnosis | Based on DSM-5 criteria, requiring at least five out of nine major symptoms to be present for two weeks or more. | Based on a clear stressor and the reaction to it causing significant impairment in social or occupational functioning. |
| Relapse | Prone to relapse without proper treatment. | The risk of relapse is low once the stressor is resolved, but it can recur if the person is exposed to a similar stressor again. |
DSM-5 Diagnostic Criteria for Depression
To be diagnosed with Major Depressive Disorder based on the DSM-5, an individual must have five or more of the following nine symptoms present during the same two-week period, and at least one of the symptoms must be (1) Depressed mood or (2) Loss of interest or pleasure.
The Nine Major Symptoms
| Symptom No. | Symptom Name | Specific Content |
| (1) | Depressed Mood | Feeling sad, empty, or hopeless for most of the day, nearly every day (can be observed by others). |
| (2) | Loss of Interest or Pleasure | Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day. |
| (3) | Weight/Appetite Change | Significant weight loss or gain (e.g., a change of more than 5% of body weight in a month) without dieting, or a decrease or increase in appetite nearly every day. |
| (4) | Sleep Disturbance | Insomnia (difficulty falling or staying asleep, early morning awakening) or hypersomnia nearly every day. |
| (5) | Psychomotor Agitation or Retardation | Restlessness (agitation) or slowed-down movements and speech (retardation). This must be observable by others, not just a subjective feeling. |
| (6) | Fatigue or Loss of Energy | Fatigue or loss of energy nearly every day. |
| (7) | Feelings of Worthlessness or Excessive Guilt | Feelings of worthlessness or excessive or inappropriate guilt nearly every day. |
| (8) | Diminished Ability to Think or Concentrate | Diminished ability to think or concentrate, or indecisiveness, nearly every day. |
| (9) | Recurrent Thoughts of Death | Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. |
