An individual may react to stress by becoming anxious or depressed, by developing a physical symptom, by running away, drinking alcohol, overeating, starting an affair, or in limitless other ways. Common subjective responses are anxiety, sadness, fear, rage, guilt, and shame. Acute and reactivated stress may be manifested by restlessness, irritability, fatigue, increased startle reaction, and a feeling of tension. Inability to concentrate, sleep disturbances (insomnia, bad dreams), and somatic preoccupations sometimes lead to self-medication, most commonly with alcohol or other central nervous system depressants. Emotional and behavioral distressing symptomatology in response to stress is called adjustment disorder, with the major symptom specified (eg, “adjustment disorder with depressed mood”). Even with an identifiable stressor, if the patient meets syndromal criteria for another disorder such as major depression, then the convention would be to diagnose a major depression and not an adjustment disorder with depressed mood.