Adjustment disorder with depressed mood and major depressive disorder (MDD) share some similar symptoms. However, they are distinct mental health conditions.

Adjustment disorder involves the development of behavioral or emotional symptoms within 3 months of an identifiable event or stressor. It causes noticeable distress and affects a person’s work, school, or personal life.

A person with adjustment disorder may experience a depressed mood that can cause feelings of hopelessness, low mood, and sadness.

Major depressive disorder (MDD) is a common mental health condition associated with a depressed mood and changes in how a person feels, thinks, and acts.

Though the two conditions share some similarities, they are two distinct conditions. This article reviews the differences between the two conditions, what each condition is, treatment strategies, and when to seek help.

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Adjustment disorder with depressed mood and MDD are two distinct mental health conditions with different diagnostic criteria, causes, and symptom duration. They do share some similarities in presenting symptoms and treatment options. However, a healthcare or mental health professional can determine what condition is causing symptoms.

Diagnostic criteria

Diagnostic criteria are the factors a healthcare or mental health professional looks for to determine if a person has a certain medical condition.

The diagnostic criteria for adjustment disorder include:

  • experiencing psychological or behavioral symptoms within 3 months of a known stressor or stressors
  • symptoms improve within 6 months after the stressor or stressors are removed
  • having more distress than would be ordinary in response to a specific stressor, distress that causes issues with work, school, or relationships, or experiencing both
  • another mental health or other condition cannot better explain the symptoms

In addition, a doctor will specify whether a person also presents with:

  • low mood
  • tearfulness (sadness)
  • feelings of hopelessness

By comparison, MDD diagnosis requires a person to present with at least five symptoms of depression every day, nearly all day, for at least 2 weeks. At least one of the symptoms must be a depressed mood or loss of interest or pleasure in all activities.

During diagnosis, a doctor may ask several questions to determine the cause of a person’s symptoms. It may help a person to record how they are feeling, when they feel it, and when the feelings started.

This may help a doctor differentiate between possible causes of the symptoms and help them arrive at an appropriate diagnosis.


The causes of adjustment disorder with depressed mood and MDD are not the same.

Stressful life events can trigger or cause adjustment disorder with depressed mood to occur. Some examples include:

  • trouble with or worrying about money
  • major disaster
  • death of a loved one
  • issues with a relationship or divorce
  • illness or other health issues in oneself or others
  • moving, switching jobs or schools, or other stressful events

The exact cause of depression is still not clear, but experts do know it can affect anyone. Possible risk factors include:

  • genetics or family history
  • personality, those who have trouble handling stress or with low self-esteem may be more likely to develop MDD
  • differences in chemicals within the brain
  • environmental factors such as abuse, neglect, or living in poverty

Symptom duration

MMD symptoms must occur daily for most of the day for at least 2 weeks to be diagnosed. Treatments and responses to treatment can affect how long symptoms will last.

Adjustment disorder with depressed mood will begin within 3 months of a known stressor and does not last for longer than 6 months after the end of the event.

In general, MDD can have varying lengths and could last for a long period of time, while adjustment disorder symptoms will typically clear within 6 months following the end of a stressful event.

However, it is possible a person may develop chronic adjustment disorder lasting for longer than 6 months.

Adjustment disorder with depressed mood is a mental health condition that occurs within a few months of a major stressor. This can include the death of a loved one, a cancer diagnosis, or other major stressors that can occur in a person’s life.

It occurs when a person has a difficult time coping with what they have gone through. It is often self-limiting and will clear within about 6 months from the end of the event.

According to a 2017 study observing over 600 randomly selected patients from an outpatient psychiatric clinic from 2008–2009, the prevalence rate of adjustment disorder was about 11.5%. Researchers found that adjustment disorder with depressed mood was one of the most common types.

Risk factors they noted included:

  • younger age
  • low educational level
  • single
  • students
  • living in urban areas

Other studies have looked at prevalence rates based on specific events. For example, a 2016 study looked at the prevalence of the condition following severe injury and reported the number at 19% 3 months following hospitalization and 16% after 1 year.

Another study from 2018 looked at prevalence after job loss. Researchers found an overall prevalence of about 27%. They found prevalence differences between males and females with rates of about 14% and 17%, respectively.

Learn more about adjustment disorder.

MDD is a common form of depression. It affects about 1 in 15 adults each year, and it is estimated to affect 1 in 6 adults at some point in their life. It can occur at any age, but it often develops in a person’s late teens to mid-20s.

Females have a higher chance of developing MDD compared to males, with an estimated 1/3 experiencing it at some point during their life.

MDD causes changes in how a person feels, thinks, and behaves. A person can present with several different symptoms and may not show the same signs as other people with the same condition.

Learn more about major depressive disorder.

Both MDD and adjustment disorders with depressed mood have similar treatments. A person will often benefit from a combination of different therapeutic approaches, including:

  • medications, such as antidepressants, anxiety medications, or other classes of drugs
  • therapy, such as cognitive behavior therapy (CBT), speaking with a mental health professional, group or family therapy, or crisis intervention

Symptoms of adjustment disorders tend to improve with the removal of the stressor or through a person learning new coping skills through therapy. A person with depression may benefit from a combination of medications and therapy.

In both cases, a person’s treatment will likely be the most effective when the treatment is individualized to fit their needs.

A person who finds that their mood, feelings, or thoughts interfere with their daily life should consider speaking with a healthcare or mental health professional. They can help identify possible causes or refer a person to a mental health specialist for diagnosis.

A person in crisis or who is contemplating suicide should call 988, the Suicide Hotline. It is available 24 hours a day, 7 days a week, all year long.

Adjustment disorder with depressed mood can present similarly to MDD. However, it typically has an identified cause and will improve either with treatment or due to the removal of the stressor causing the condition.

MDD may not have a clear cause. Symptoms typically last at least 2 weeks and could last for a long time if not treated.

It’s important that a person speak with a healthcare or mental health professional for proper diagnosis. Once a diagnosis is given, a healthcare professional can help a person in seeking proper treatment that can help them manage their symptoms and begin to regain typical activity levels.