Adjustment disorder is distress or impairment in response to a specific life stressor that begins within three months of the event and exceeds the expected reaction. It is treated primarily with brief psychotherapy focused on coping and problem-solving, with short-term medication for sleep or anxiety when needed. Most people recover within six months once the stressor resolves or they adapt. Stedfast Psychiatry treats adjustment disorder and life stress at 10301 Hagen Ranch Rd in Boynton Beach and by video across Florida; new patients call (561) 437-2179.
Adjustment Disorder and Life Stress at our Boynton Beach office
The Boynton Beach office at 10301 Hagen Ranch Rd, Suite D720 and Suite B710 serves Valencia Lakes, Valencia Isles, Aberdeen, Indian Spring and Palm Isles and the surrounding communities of Delray Beach, Lake Worth Beach, Greenacres, Lantana and Hypoluxo. Bethesda Health City campus is a useful landmark for first-time visitors.
Call (561) 437-2179 to book, or request an appointment online and we will call you back. The office is open weekdays 8:00 AM to 5:00 PM. The office sits on the Bethesda Health City medical campus at the corner of Hagen Ranch Road and West Boynton Beach Boulevard, in the western part of Boynton Beach. From I-95, take exit 59 for Boynton Beach Boulevard and drive west for about five miles, past Jog Road and Military Trail, then turn left onto Hagen Ranch Road.
Spravato (esketamine) sessions are delivered on site in Boynton Beach. Deep TMS is delivered at our Palm Beach Gardens office, about 35 minutes away, and the evaluation can be done here.
Who you will see in Boynton Beach
The Boynton Beach team includes psychiatrists Dr. Peter Gobar and Ana Paula Aun, psychiatric nurse practitioners Sara Hetzler, Andres Luque, Michael Carraturo, Leetal Kirshenberg, Dara Castillo and Kayla Marzullo and physician assistant Madison Algayer. Visits in Spanish and Portuguese are available with Andres Luque and Ana Paula Aun. Children and teens are seen by Sara Hetzler, Madison Algayer, Leetal Kirshenberg and Dara Castillo.
Dr. Peter Gobar, MD
Psychiatrist · Adults
Sara Hetzler, PMHNP-BC
Psychiatric Nurse Practitioner · Children, adolescents and adults
Andres Luque, PMHNP-BC
Psychiatric Nurse Practitioner · Adults 18 to 80 · English, Spanish
Madison Algayer, PA-C
Physician Assistant · Adults and teens 16+
Michael Carraturo, PMHNP-BC
Psychiatric Nurse Practitioner · Ages 10 and up
Leetal Kirshenberg, PMHNP-BC
Psychiatric Nurse Practitioner · Ages 8 and up
Signs of adjustment disorder and life stress
- Sadness, tearfulness or hopelessness tied to a specific event
- Worry, nervousness or feeling overwhelmed since the stressor
- Trouble sleeping or concentrating
- Withdrawing from friends, family or activities
- Irritability, anger or conflict at home or work
- Difficulty performing at work or school since the event
- Physical complaints such as headaches, stomach upset or fatigue
- Increased drinking or other risky behavior to cope
How we diagnose it
We diagnose adjustment disorder through a clinical interview that identifies the stressor, the timing and nature of your symptoms, how they are affecting your functioning, and your prior history. We specify the subtype (with depressed mood, with anxiety, with mixed anxiety and depressed mood, with disturbance of conduct, or mixed), which guides treatment. We use the PHQ-9 and GAD-7 to measure severity, and we carefully assess whether the symptoms meet criteria for major depression, generalized anxiety disorder, PTSD or a substance use disorder, since adjustment disorder is diagnosed only when they do not. We ask about alcohol and substance use, sleep, physical symptoms, and suicidal thoughts, which occur in adjustment disorder more often than people assume. Labs are ordered when fatigue or physical symptoms suggest a medical contributor.
Adjustment disorder is diagnosed in roughly 5 to 20 percent of outpatient mental health patients and up to 50 percent of patients seen in hospital psychiatric consultation.
Source: American Psychiatric Association, DSM-5-TR
Among people with cancer, adjustment disorder affects an estimated 15 to 20 percent, making it more common than major depression in that population.
Source: Mitchell et al., Lancet Oncology, 2011 meta-analysis
By definition, adjustment disorder symptoms resolve within six months of the stressor or its consequences ending; symptoms that persist beyond that suggest a different diagnosis.
Source: American Psychiatric Association, DSM-5-TR
Suicidal behavior occurs in adjustment disorder, and in one large study adjustment disorder accounted for a substantial share of psychiatric diagnoses among people presenting after a suicide attempt.
Source: Casey et al., Journal of Affective Disorders, 2015
Treatment for adjustment disorder and life stress in Boynton Beach
Medication management
Psychotherapy is the primary treatment and many patients need no medication. When symptoms are impairing, short-term medication helps: hydroxyzine or, briefly, a low-dose benzodiazepine for acute anxiety; low-dose trazodone or doxepin for insomnia, which, if left untreated, prolongs recovery. If depressive or anxiety symptoms are moderate to severe, persist beyond a few weeks, or are moving toward major depression, an SSRI such as sertraline or escitalopram is reasonable, usually for six to twelve months. We review the need for medication at each visit with the goal of stopping once you have adapted, and we avoid long-term benzodiazepines.
Psychotherapy
Brief therapy is the core treatment. Problem-solving therapy helps you break an overwhelming situation into manageable parts and act on what can be changed. Cognitive behavioral therapy addresses the thoughts that keep stress amplified (catastrophizing, self-blame, all-or-nothing thinking) and rebuilds routines and activity. Supportive and interpersonal approaches help with role transitions and relationship changes. Mindfulness and stress-management training build tolerance for what cannot be changed. Typical treatment is four to twelve sessions. For medical diagnoses, therapy integrates with your medical care; for workplace stress, we can provide documentation for leave or accommodations.
What to expect
Your first visit is a 45 to 60 minute evaluation, in person or by video, focused on what happened, how you are coping, and what is not working. You leave with a plan: usually brief therapy, sometimes with short-term medication for sleep or anxiety, and a check for depression or other conditions. Follow-ups are every two to four weeks while symptoms are active. Most patients complete treatment in two to four months. Telehealth is available across Florida and South Carolina and fits well with the practical, time-limited nature of this treatment.
The complete guide, including causes, subtypes and research, is on our Adjustment Disorder and Life Stress page.
Emergency and crisis resources near Boynton Beach
In an emergency, call 911 or go to Bethesda Hospital West Emergency Room (9655 W Boynton Beach Blvd, Boynton Beach). The 988 Suicide and Crisis Lifeline is available by call or text 24 hours a day. Bethesda Hospital East Emergency Room and 988 Suicide and Crisis Lifeline are also listed on the Boynton Beach office page.
Frequently asked questions
Who provides adjustment disorder and life stress treatment at the Boynton Beach office?
The Boynton Beach team includes psychiatrists Dr. Peter Gobar and Ana Paula Aun, psychiatric nurse practitioners Sara Hetzler, Andres Luque, Michael Carraturo, Leetal Kirshenberg, Dara Castillo and Kayla Marzullo and physician assistant Madison Algayer. Visits in Spanish and Portuguese are available with Andres Luque and Ana Paula Aun. Every provider works under psychiatrist oversight and the same evaluation standard: about an hour for a first visit, validated screening scales, and a written plan.
Can I be seen by video instead of coming to Boynton Beach?
Yes. Stedfast Psychiatry providers are licensed in Florida and offer video visits for evaluations and follow-ups. Some situations, including certain controlled-substance prescriptions and first visits for young children, require an in-person appointment at 10301 Hagen Ranch Rd.
Does the Boynton Beach office take my insurance?
We accept most major commercial plans and Medicare. Call (561) 437-2179 with your member ID and we will verify benefits before the visit. Self-pay new-patient evaluations are $185.
How soon can a new patient be seen in Boynton Beach?
Most new patients are scheduled within one to two weeks. If you need to be seen sooner, ask about a video visit; those often open up within days. If you are in crisis, call or text 988 or go to the nearest emergency room rather than waiting.
Can I get Deep TMS or Spravato as a Boynton Beach patient?
Yes. Stedfast Psychiatry is licensed for both. Your Boynton Beach provider does the evaluation and the prior authorization; treatment sessions are scheduled at our Palm Beach Gardens TMS center and the Boynton Beach Spravato rooms (Spravato is on site here).
What is the difference between adjustment disorder and depression?
Adjustment disorder is a reaction to a specific stressor that does not meet the full criteria for major depression: the symptoms are tied to the event, usually less pervasive, and expected to resolve within six months of the stressor ending. Major depression involves at least two weeks of pervasive low mood or loss of interest with several other symptoms, and it can continue regardless of circumstances. Adjustment disorder can progress to major depression, which is why we reassess at every visit.
Do I need medication for adjustment disorder?
Often not. Brief therapy is the primary treatment and resolves most cases. Short-term medication for sleep or acute anxiety can help you function while you work through the situation, and an SSRI is reasonable if symptoms are moderate to severe or persist. Any medication is reviewed regularly with the goal of stopping once you have adapted. We will give you a clear recommendation rather than a prescription by default.
Nearby Stedfast offices
If you are in crisis, call or text 988 or go to the nearest emergency room. Educational content; individual results vary. Reviewed by Dr. David Husted, board-certified psychiatrist.