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.
In this article, we discuss what ASD is and its symptoms and causes. We also cover diagnosis, treatment, and prevention.
What is ASD?
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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.
People who have ASD experience symptoms similar to those of PTSD and other stress disorders.
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
- racing thoughts
Symptoms of depression include:
- persistent feelings of hopelessness, sadness, or numbness
- crying unexpectedly
- loss of interest in activities that were once pleasurable
- changes in appetite or body weight
- thoughts of suicide or self-harm
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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
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
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
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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.
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
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.
Reaching out to friends, family, and community support groups can also help a person process their feelings and move on with their life following a traumatic event.
Acute stress disorder is a psychiatric diagnosis that may occur in patients within four weeks of a traumatic event. Features include anxiety, intense fear or helplessness, dissociative symptoms, reexperiencing the event, and avoidance behaviors. Persons with this disorder are at increased risk of developing posttraumatic stress disorder. Other risk factors for posttraumatic stress disorder include current or family history of anxiety or mood disorders, a history of sexual or physical abuse, lower cognitive ability, engaging in excessive safety behaviors, and greater symptom severity one to two weeks after the trauma. Common reactions to trauma include physical, mental, and emotional symptoms. Persistent psychological distress that is severe enough to interfere with psychological or social functioning may warrant further evaluation and intervention. Patients experiencing acute stress disorder may benefit from psychological first aid, which includes ensuring the patient’s safety; providing information about the event, stress reactions, and how to cope; offering practical assistance; and helping the patient to connect with social support and other services. Cognitive behavior therapy is effective in reducing symptoms and decreasing the future incidence of posttraumatic stress disorder. Critical Incident Stress Debriefing aims to mitigate emotional distress through sharing emotions about the traumatic event, providing education and tips on coping, and attempting to normalize reactions to trauma. However, this method may actually impede natural recovery by overwhelming victims. There is insufficient evidence to recommend the routine use of drugs in the treatment of acute stress disorder. Short-term pharmacologic intervention may be beneficial in relieving specific associated symptoms, such as pain, insomnia, and depression.
Acute stress disorder (ASD) typically occurs within one month of a traumatic event. Symptoms are similar to those seen in post traumatic stress disorder (PTSD), however this disorder is temporary, lasing from a few days to a month. Some people with this disorder can go on to develop PTSD.
What’s 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 three days and can persist for up to one month. People with ASD have symptoms similar to those seen in post-traumatic stress disorder (PTSD).
What causes acute stress disorder?
Experiencing, witnessing, or being confronted with one or more traumatic events can cause ASD. The events create intense fear, horror, or helplessness. Traumatic events that can cause ASD include a:
- threat of death to oneself or others
- threat of serious injury to oneself or others
- threat to the physical integrity of oneself or others
Approximately 6 to 33 percent of people who experience a traumatic event develop ASD, according to the U.S. Department of Veterans Affairs. This rate varies based on the nature of the traumatic situation.
Who’s 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
- a history of ASD or PTSD
- a history of certain types of mental problems
- a history of dissociative symptoms during traumatic events
What are the symptoms of acute stress disorder?
The symptoms of ASD include:
You’ll have three or more of the following dissociative symptoms if you have ASD:
- feeling numb, detached, or being emotionally unresponsive
- a reduced awareness of your surroundings
- derealization, which occurs when your environment seems strange or unreal to you
- depersonalization, which occurs when your thoughts or emotions don’t seem real or don’t seem like they belong to you
- dissociative amnesia, which occurs when you cannot remember one or more important aspects of the traumatic event
Reexperiencing the traumatic event
You’ll persistently re-experience 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’re reliving the traumatic event
- feeling distressed when something reminds you of the traumatic event
You may avoid stimuli that cause you to remember or re-experience the traumatic event, such as:
Anxiety or increased arousal
The symptoms of ASD may include anxiety and increased arousal. The symptoms of anxiety and increased arousal include:
- having trouble sleeping
- being irritable
- having difficulty concentrating
- being unable to stop moving or sit still
- being constantly tense or on guard
- becoming startled too easily or at inappropriate times
The symptoms of ASD may cause you distress or disrupt important aspects of your life, such as your social or work settings. You may have an inability to start or complete necessary tasks, or an inability to tell others about the traumatic event.
How’s acute stress disorder diagnosed?
Your primary 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
- side effects of medications
- health problems
- other psychiatric disorders
If you don’t already have a primary care doctor or a mental healthcare professional, you can browse doctors in your area through the Healthline FindCare tool.
What’s the long-term outlook?
Many 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 difficulty functioning.
Treatment may reduce your chances of developing PTSD. Approximately 50 percent of PTSD cases resolve within six months, whereas others may persist for years.
Can I prevent ASD?
Because there’s no way to ensure that you never experience a traumatic situation, there’s no way to prevent ASD. However, there are things that can be done to reduce your likelihood of developing ASD.
Getting medical treatment within a few hours of experiencing a traumatic event may reduce the likelihood that you’ll develop ASD. People who work in 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 involve fake enactments of traumatic events and counseling to strengthen coping mechanisms.