Posttraumatic Stress Disorder

What is acute stress disorder?

Acute stress disorder is a mental health condition that can occur immediately after a traumatic event. It can cause a range of psychological symptoms and, without recognition or treatment, it can lead to post-traumatic stress disorder.

There is a close relationship between acute stress disorder (ASD) and post-traumatic stress disorder (PTSD). Some people develop PTSD after having ASD.

According to the United States Department of Veterans Affairs, approximately 19 percent of people will develop ASD after experiencing a traumatic event. Everyone responds to traumatic events differently, but it is important to be aware of the potential physical and psychological effects that can occur afterward.

What is ASD?

Experiencing psychological distress, following a traumatic event, is a sign of ASD.
ASD is a relatively new psychological diagnosis. The American Psychiatric Association first introduced it to the fourth edition of the Diagnostic and Statistical Manual of Mental Health Disorders in 1994.

Although it shares many of the same symptoms as PTSD, ASD is a distinct diagnosis.

A person with ASD experiences psychological distress immediately following a traumatic event. Unlike PTSD, ASD is a temporary condition, and symptoms typically persist for at least 3 to 30 days after the traumatic event.

If a person experiences symptoms for longer than a month, a doctor will usually assess them for PTSD.

Symptoms of PTSD

Symptoms of PTSD vary widely, but clinical PTSD diagnosis requires the presence of symptoms from each of the following categories. For an acute trauma reaction to become clinical PTSD, symptoms must persist for more than a month.

• Intrusive symptoms like flashbacks and/or nightmares: You may find yourself reliving the memory of the traumatic event or having nightmares about trauma.
• Avoidance symptoms: You might avoid thoughts or experiences that remind you of the traumatic event.

Indications related to negative thoughts or mood symptoms can include any of the following, among others:

• Angry outbursts, persistent irritation, sadness, or mood swings
• Intense anxiety and difficulty relaxing
• Feelings of guilt or shame, possibly including a sense that the trauma was somehow your fault
• Arousal symptoms like being easily startled, tense, or jumpy
• Emotional numbness or lack of energy
• Control symptoms like self-destructive behavior including substance abuse

In addition to these behavioral symptoms, some people also experience physical symptoms including headaches, digestive issues, and/or changes in eating, or sleep problems.

ASD symptoms fall under five broad categories:

Intrusion symptoms. These occur when a person is unable to stop revisiting a traumatic event through flashbacks, memories, or dreams.
Negative mood. A person may experience negative thoughts, sadness, and low mood.
Dissociative symptoms. These can include an altered sense of reality, a lack of awareness of the surroundings, and an inability to remember parts of the traumatic event.
Avoidance symptoms. People with these symptoms purposefully avoid thoughts, feelings, people, or places that they associate with the traumatic event.
Arousal symptoms. These can include insomnia and other sleep disturbances, difficulty concentrating, and irritability or aggression, which can be either verbal or physical. The person may also feel tense or on guard and become startled very easily.
People with ASD may develop additional mental health disorders, such as anxiety and depression.

Symptoms of anxiety include:

feeling a sense of impending doom
excessive worrying
difficulty concentrating
fatigue
restlessness
racing thoughts

Symptoms of depression include:

persistent feelings of hopelessness, sadness, or numbness
fatigue
crying unexpectedly
loss of interest in activities that were once pleasurable
changes in appetite or body weight
thoughts of suicide or self-harm

Causes

Traumatic events, such as the death of a loved one, can cause a person to develop ASD.
People can develop ASD after experiencing one or more traumatic events. A traumatic event can cause significant physical, emotional, or psychological harm.

Among others, possible traumatic events can include:

the death of a loved one
the threat of death or serious injury
natural disasters
motor vehicle accidents
sexual assault, rape, or domestic abuse
receiving a terminal diagnosis
surviving a traumatic brain injury
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Risk factors

A person can develop ASD at any point in their life. However, some people may have a higher risk of developing this condition.

Factors that can increase an individual’s risk of developing ASD include:

previously experiencing, witnessing, or having knowledge of a traumatic event
a history of other mental health disorders
a history of dissociative reactions to past traumatic events
being younger than 40 years old
being female

Diagnosis

A doctor or mental health professional can diagnose ASD. They will ask questions about the traumatic event and the person’s symptoms.

A healthcare professional will usually diagnose ASD if a person develops nine or more ASD symptoms within 1 month of the traumatic event. Symptoms that appear after this time frame or persist longer than 1 month may indicate PTSD.

To diagnose ASD, a healthcare professional will also rule out other possible causes, such as:

other psychiatric disorders
substance use
underlying medical conditions

Treatment

Practicing mindfulness-based techniques can help manage stress and anxiety.
A healthcare professional will work closely with a person to develop a treatment plan that meets their individual needs. Treatment for ASD focuses on reducing symptoms, improving coping mechanisms, and preventing PTSD.

Treatment options for ASD may include:

Cognitive behavioral therapy (CBT). Doctors usually recommend CBT as the first-line treatment for people with ASD. CBT involves working with a trained mental health professional to develop effective coping strategies.
Mindfulness. Mindfulness-based interventions teach techniques for managing stress and anxiety. These can include meditation and breathing exercises.
Medications. A healthcare professional may prescribe antidepressants or anticonvulsants to help treat a person’s symptoms.

Prevention

It is not always possible to avoid experiencing traumatic events. However, there are ways to reduce the risk of developing ASD afterward.

These can include:

consulting a doctor or mental health professional following a traumatic event
seeking support from family and friends
getting treatment for other mental health disorders
working with a behavioral coach to develop effective coping mechanisms
getting preparation training if a person’s job involves a high risk of exposure to traumatic events

Summary

ASD is not an uncommon condition, and it can occur after a person experiences a traumatic event. People whose occupation exposes them to traumatic events have a higher risk of developing ASD.

ASD has a close relationship with PTSD and shares many of the same symptoms. However, ASD is a short-term condition that typically resolves within a month, whereas PTSD is a chronic condition. If a person has symptoms of ASD for longer than a month, a doctor may assess the person for PTSD.

Treatment aims to reduce symptoms and help a person develop effective coping strategies. Options include CBT, mindfulness techniques, and medications.