Key Takeaways
- Acute stress disorder (ASD) is a recognized psychological disorder that can occur after a traumatic event.
- ASD differs from PTSD in that it occurs soon after a traumatic event and lasts no more than one month.
- ASD involves emotional, psychological, and physical symptoms and can be treated with psychotherapy.
I was in a car accident over a decade ago, but I remember the event like it was yesterday. Crash! Boom! Lights and sirens. I get checked out, and I’m cleared when the tow truck comes. I’m numb. I don’t cry, scream, or show any emotion. It doesn’t hit me until a couple of days later.
Experiencing an extremely stressful event has a profound impact on your life. Could you have post-traumatic stress disorder (PTSD)? Or could it be a different mental health condition triggered by traumatic events called acute stress disorder?
What Is Acute Stress?
Julia Kogan, PsyD, a health psychologist and stress and insomnia specialist, explains that acute stress disorder (ASD) is a cluster of symptoms that occurs within a month of experiencing a traumatic event.
A traumatic event is an occurrence that causes the person to experience significant distress, fear, or risk of death. These can include assaults, accidents, injuries, or life-threatening situations.
It’s hard to say how many of us have ASD, as it is highly variable and dependent on the type of traumatic event and duration of symptoms.
A systematic review looked at the prevalence of acute stress disorder following a violence-related injury treated at the emergency department. It showed that ASD was reported less than one week after the injury at 24.0% to 24.6% and one to two weeks after the injury at 11.7% to 40.6%.
Dr. Kogan shares that you may have a higher risk of developing ASD if:
- You have prior trauma
- You have a mental health condition
- You cope by avoiding
- You’re experiencing trauma related to an assault
“It is helpful to know that not everyone who experiences a traumatic event will meet the criteria for acute stress disorder. This will largely depend on how the person experiences the event, their general coping skills, pre-existing mental health concerns, and other factors,” Dr. Kogan says.
Signs You’re Experiencing Acute Stress
Dr. Kogan says that symptoms of ASD may include:
- High levels of stress and anxiety
- Avoiding reminders of the event
- Distressing memories or nightmares about the event
- Disruptions in sleep and focus
- Feeling more on guard
“Not only does someone experience these symptoms, but these symptoms cause a disturbance in day-to-day life, such as at work, socially, or other areas of functioning,” Dr. Kogan says.
Allison Paugh, a psychiatric mental health nurse practitioner (PMHNP), shares the following emotional, physical, and psychological symptoms of ASD:
Emotional Symptoms
Emotional symptoms can include:
- Inability to feel happy, successful, or in love
- Feelings of numbness
- Avoiding thoughts or memories associated with the traumatic event
- Avoiding people or places that may remind you of the traumatic event
- Irritability
- Distressing memories
Physical Symptoms
Physical symptoms can include:
- Tachycardia (fast heart rate)
- Strong startle response
- Panic, including shortness of breath, feeling of choking, or feeling as if you are actively dying
- Gastrointestinal (GI) symptoms such as “anxious stomach”, upset stomach, and nausea
Psychological Symptoms
Psychological symptoms can include:
- Insomnia
- Nightmares
- Distractibility
- Hypervigilance (abnormally alert to surroundings)
- Detachment from self and emotions
- Dissociative amnesia (memory gaps about important information about yourself)
Is Acute Stress Always a Bad Thing?
Acute stress is a natural, temporary response to perceived threat or pressure. But if unmanaged or frequent, Dr. Kogan explains that acute stress disorder can have a significant impact at work, in relationships, and in activities of daily living.
For instance, people may have difficulty focusing due to higher levels of stress, sleep disturbances, and intrusive memories, making it hard to work. Their relationships may be negatively impacted due to increased irritability, feelings of detachment or numbness, or isolation.
She says that ASD can affect physical health as higher levels of stress and anxiety can increase blood pressure, impact heart health, and cause other physical issues. Some individuals may engage in negative coping behaviors such as using alcohol or other substances excessively.
How Does ASD Differ From PTSD or Adjustment Disorder?
Paugh explains that the primary difference between ASD and PTSD is duration:
- ASD occurs for at least 3 days and lasts up to 1 month after the event. ASD can often be a predictor of PTSD.
- PTSD symptoms occur for more than 1 month. While ASD can occur immediately after an event, PTSD can develop months or even years after the traumatic event.
She says that ASD is typically diagnosed after a traumatic event causing an acute stress reaction; however, adjustment disorder is usually the result of less severe events that may not be traumatic (i.e., losing a job, breaking up in a relationship, moving to a new school, or environment).
When Acute Stress Becomes a Pattern
Paugh explains that most people can recover from ASD once removed from the event, environment, or situation, and are provided support that is understanding or empathetic of their distress:
- Psychotherapy: Trauma-focused cognitive behavioral therapy (CBT) is considered the first line of treatment and is an evidence-based practice for those with ASD. She adds that this form of therapy can help reduce the risk of ASD evolving into PTSD.
- Professional support: Psychotherapists and health care providers can provide professional support by explaining symptoms, recovery, and coping skills. Assessment of suicidality is vital during these visits.
- Psychotropic medication: Paugh says psychotropic medication may be needed if symptoms are severe and distressing. Currently, there is a limited number of medications specifically for ASD; however, there are some for PTSD that help with some of the same symptoms as ASD. The treatment plan can also include medication to assist with sleep problems and nightmares.
- Support by loved ones: Paugh shares that if you have a loved one with ASD, practical and emotional support is crucial for their recovery. This could involve assisting the person in completing police reports (if an assault or accident has occurred), setting up appointments, filing work release forms, and offering comfort and empathy.
“Reaching out for professional help is recommended for anyone experiencing acute stress disorder symptoms. The sooner they can reach out to someone, the more likely they are to be able to manage symptoms and prevent posttraumatic stress disorder. Working with a trained professional qualified in trauma-focused CBT is considered the best clinical practice,” Dr. Kogan advises.
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