Acute stress disorder: Causes, symptoms, and treatment

What Is Acute Stress Disorder?

Acute stress disorder (ASD) is a mental health condition that begins shortly after a traumatic experience, often within a month. It is characterized by psychological/mental shock, severe anxiety, and other difficult symptoms, which typically last for a month or less. 

Traumatic events may vary greatly, and usually, the event is (or is perceived as) life-threatening. An example of this is a car crash – those in the crash as well as witnesses who were not directly affected are at risk of acute stress. However, the more directly exposed to a traumatic event a person is, the higher the risk for mental harm. 

The physiological response behind ASD is called the acute stress response. When something perceives a threat, they have an automatic response that is to either confront or flee the situation — this is where the term “fight-or-flight response” comes from. The response is almost instantly accompanied by a spike in heart rate, blood pressure, breathing, and metabolism, as well as feeling sweaty and muscles tensing up. 

In fact, when people experience trauma, they may continue to feel like there are constant threats in their environment due to perceived danger (due to intrusive, distressing memories or dreams) and experience the acute stress response more frequently.

What Are the Symptoms of Acute Stress Disorder (DSM)?

People with ASD may experience dissociation, intrusion, avoidance, and anxiety & hyperarousal symptoms. 

Dissociative Symptoms

Numbness, reduced awareness of one’s surroundings, depersonalization (thoughts/emotions don’t feel real), derealization (environment doesn’t feel real), and dissociative amnesia (in which the individual can’t remember important details from the trauma) are all dissociative symptoms. People with ASD will have at least three of these. 

Intrusive Symptoms

Intrusion is described as re-experiencing a traumatic event. The individual will have distressing memories of the event, recurrent dreams, and/or flashbacks. These are usually very intense and cause great psychological distress to the person. 

Avoidant Symptoms

When a person is in avoidance, they will try to prevent thoughts or feelings from surfacing that would cause them to remember or re-experience the event. They will go to great lengths to avoid people, places, objects, activities, and conversations.

Anxious & Hyperarousal Symptoms

People with ASD can have difficulty sleeping and be extra cautious. In addition, the person may be startled easily as well as engage in reckless or aggressive behavior themselves. They may feel separated from other people, blame the event on themselves, or have little pleasure or interest in the things they used to enjoy.

How to Identify If You’re Experiencing ASD?

If you’re experiencing the symptoms listed above during or following a traumatic event, you might be experiencing ASD. The only way to know for sure is to meet with a medical professional. 

A doctor or mental health professional can ask questions about your traumatic experience, symptoms, and more, to determine if you have ASD. A diagnosis typically requires that at least 9 or more ASD symptoms are present within 1 month of the trauma.

Acute Stress Disorder vs. PTSD

What’s the Difference Between PTSD and Acute Stress Disorder?

While many symptoms of ASD overlap with those of post-traumatic stress disorder (PTSD), one of the differences is that an acute stress disorder is temporary — it can last for just a few days, up to one month. PTSD symptoms, on the other hand, must be present for at least a month and can continue for many years, especially without treatment. Some people with acute stress disorder go on to develop PTSD. 

Causes and Contributors: How Do You Get Acute Stress Disorder?

A person can develop ASD from a variety of traumatic events, including:

• Death of a loved one
• Severe accidents
• War
• Rape or sexual violence
• A physical attack
• Mugging
• Kidnapping or being taken as a hostage
• Terrorist attacks
• Natural disasters

Who Is at Higher Risk for Acute Stress Disorder?

While anyone can develop acute stress disorder after experiencing trauma, there are several factors that can put people at a higher risk:

• Other past traumatic experiences
• Personal history of ASD or PTSD
• Family history of ASD or PTSD
• History of other mental health problems

In addition, males are four times more likely to develop ASD than their female counterparts. 

Treatment of Acute Stress Disorder

“Treatment approaches are individualized based on the needs of the individual but focus on support, discussion about the acute or post-traumatic event at the rate of the individual’s ability to converse, and education about the diagnosis and treatment options including techniques for coping,” explains Tamiqua Jackson, Psychiatric Mental Health Nurse Practitioner at Thriveworks.  

One of the most successful treatments for ASD is cognitive behavioral therapy (CBT). Its goal is to change the thought patterns that surround the traumatic event. In addition, CBT works to change behaviors in situations that cause anxiety. CBT also works to keep the person with ASD from developing PTSD. 

Other treatments that seem to work well for individuals with ASD are anxiety management groups and psychological debriefing, or the intense therapeutic intervention immediately following the event so that the individual can “talk about it.” However, some people undergoing psychological debriefing find that it causes them to be re-traumatized by talking about the event that had caused them pain.

Preventative Care for Acute Stress Disorder

It’s important to get medical treatment within a few hours of experiencing a traumatic event. This will decrease the chance of developing ASD. Individuals who work in jobs that have a high risk for traumatic events, such as those in the military, may find it beneficial to undergo preparation training and counseling. This may lessen their chance of developing ASD or PSTD if such an event should happen. 

Preparation training might include fake enactments of the traumatic events that could occur. Counseling may be ideal in helping them strengthen their coping mechanisms.