Acute Stress Disorder

Written by Rose Kivi
Medically Reviewed by George Krucik, MD

What Is Acute Stress Disorder?

In the weeks after a traumatic event, you may develop an anxiety disorder called acute stress disorder (ASD). ASD typically occurs within one month of a traumatic event. It lasts at least two days and up to one month. People with ASD have symptoms similar to those seen in post-traumatic stress disorder (PTSD).

Approximately six to 33 percent of people who experience a traumatic event develop ASD. Examples of traumatic events include, but are not limited to, rape, physical assault, near-death experiences, witnessing a murder, combat, and having a child in a neonatal intensive care unit.

What Causes Acute Stress Disorder?

ASD is caused by experiencing, witnessing, or being confronted with a traumatic event or events. The events create intense fear, horror, or helplessness. Traumatic events that can cause ASD include:

  • death
  • the threat of death to oneself or others
  • the threat of serious injury to oneself or others
  • a threat to the physical integrity to oneself or to others

Who Is at Risk for Acute Stress Disorder?

Anyone can develop ASD after a traumatic event. You may have an increased risk of developing ASD if you:

  • have experienced, witnessed, or been confronted with a traumatic event in the past
  • have had ASD or PTSD in the past
  • have had mental problems in the past
  • have had dissociative symptoms during traumatic events

What Are the Symptoms of Acute Stress Disorder?

Symptoms you may experience if you have ASD include:

Dissociative Symptoms

If you have ASD you will experience three or more of the following dissociative symptoms:

  • feeling numb, detached, or being emotionally unresponsive
  • a reduced awareness of your surroundings
  • derealization (your environment seems strange or unreal to you)
  • depersonalization (your thoughts or emotions do not seem real or do not seem like they

belong to you)

  • dissociative amnesia (you cannot remember an important aspect or aspects of the traumatic event)

Reexperiencing the Traumatic Event

You will persistently reexperience the traumatic event in one or more of the following ways if you have ASD:

  • having recurring images, thoughts, nightmares, illusions, or flashback episodes of the traumatic event
  • feeling like you are reliving the traumatic event
  • feeling distressed when something reminds you of the traumatic event

Avoidance

You may avoid stimuli that cause you to remember or reexperience the traumatic event, such as:

  • people
  • conversations
  • places
  • objects
  • activities
  • thoughts
  • feelings

Anxiety or Increased Arousal

ASD symptoms may include anxiety and increased arousal. Symptoms of anxiety and increased arousal include:

  • having trouble sleeping
  • being irritable
  • having difficulty concentrating
  • inability to stop moving or sit still
  • being constantly tense or on-guard
  • becoming startled too easily or at inappropriate times

Distress

Your symptoms of ASD may cause you distress or disrupt important aspects of your life, such as:

  • social settings
  • work settings
  • inability to start or complete necessary tasks
  • inability to tell others about the traumatic event

How Is Acute Stress Disorder Diagnosed?

Your doctor or mental healthcare provider will diagnose ASD by asking you questions about the traumatic event and your symptoms. It’s also important to rule out other causes such as drug abuse, medications, health problems, or other psychiatric disorders.

How Is Acute Stress Disorder Treated?

Your healthcare provider may use one or more of the following methods to treat ASD:

  • psychiatric evaluation to determine your specific needs
  • hospitalization if you are a suicide risk or at risk of harming others
  • assistance in obtaining shelter, food, clothing, and locating family if necessary
  • psychiatric education to teach you about your disorder
  • medication to relieve symptoms of ASD, such as anti-anxiety medications, serotonin reuptake inhibitors (SSRIs), and antidepressants
  • cognitive behavior therapy (cognitive behavior therapy may increase recovery speed, and may prevent ASD from turning into PTSD)
  • exposure-based therapies
  • hypnotherapy

What is the Long Term Outlook?

The majority of people with ASD are later diagnosed with PTSD. A diagnosis of PTSD is made if your symptoms persist for more than a month and cause a significant amount of stress and difficulties functioning. Treatment may reduce your chances of developing PTSD. Approximately 50 percent of PTSD cases resolve within six months, while the others persist for years.

Can I Prevent ASD?

Because there is no way to ensure that a person never experiences a traumatic situation, there is no way to prevent ASD. There are things, however, that can be done to reduce the likelihood of someone developing ASD. Getting treatment from a healthcare provider within a few hours of experiencing a traumatic event may reduce the likelihood that you will develop ASD. People who work at jobs that carry a high-risk for traumatic events—such as military personnel—may benefit from preparation training and counseling to reduce their risk of developing ASD or PSTD if a traumatic event does occur. Preparation training and counseling may consist of fake enactments of traumatic events and counseling to strengthen coping mechanisms.

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Article Sources:

  • Acute Stress Disorder. (n.d.). U.S. Department of Veterans Affairs. Retrieved April 12, 2012, from http://www.ptsd.va.gov/public/pages/acute-stress-disorder.asp
  • Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. (n.d.). AHRQ National Guideline Clearinghouse. Retrieved April 12, 2012, from http://www.guidelines.gov/content.aspx?id=5954
  • McFarlane, A. C. (2010). The long-term costs of traumatic stress: intertwined physical and psychological consequences. World Psychiatry, 9(1), 3-10.
  • Psychiatric Association, R. A. (2000). Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR Fourth Edition (Fourth Edition Text Revision ed.). : Amer Psychiatric Pub.
  • PsychiatryOnline | APA Practice Guidelines | Practice Guideline for the Treatment of Patients With Acute Stress Disorder and Posttraumatic Stress Disorder. (n.d.). PsychiatryOnline | Home. Retrieved April 12, 2012, from http://psychiatryonline.org/content.aspx?bookid=28§ionid=1670530

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