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Acute Stress Disorder & How It Relates to PTSD

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Last updated February 27, 2021

Acute stress disorder quiz

Take a quiz to find out if you have acute stress disorder.

Acute stress disorder may be experienced after sustaining a trauma or witnessing a traumatic event. These symptoms last for about a month and can lead to PTSD.

What is acute stress disorder?

Acute stress disorder (ASD) is a psychological condition caused by trauma, especially by a violent attack like robbery, assault, or combat. "Acute" means that clear symptoms appear within days of the traumatic event. You are more susceptible if you have a history of trauma or other mental health conditions.

You may experience ASD after undergoing trauma, witnessing a traumatic event, or being close to someone affected by trauma. The symptoms last for less than one month but greatly interfere with the ability to function normally in work, school, or other settings.

Symptoms include severe anxiety as well as dissociation, which is the feeling of being outside your body and observing events from a distance. There will also be detachment, emotional numbness, and flashbacks to the traumatic event.

A psychological evaluation will determine the diagnosis. Sometimes a physical examination is done to rule out any physical causes for anxiety or depression.

Treatment involves a type of psychological counseling called cognitive behavioral therapy, or CBT, and sometimes short-term medication.

Recommended care

You should visit your primary care physician, who can do a thorough assessment and refer you to a psychiatrist if necessary. Treatment is mostly through counseling.

Acute stress disorder symptoms

Not everyone who is diagnosed with ASD will experience symptoms from all five categories of ASD symptoms.

Intrusive symptoms

These include disturbing dreams or flashbacks related to the trauma. Flashbacks are vivid memories often triggered when something reminiscent of the traumatic event occurs, such as a noise. These dreams or flashbacks are uncontrollable and interfere with everyday life.

Negative mood

People with ASD may experience sadness and lack of normal positive emotions.

Dissociative symptoms

The experience of dissociation refers to feeling that the self or surroundings are somehow unreal or distant. This category of symptoms also includes loss of memories from the traumatic experience.

Avoidant symptoms

These symptoms include going out of one's way to stay away from locations and people associated with the trauma. People with avoidant symptoms may use alcohol or other substances to block the emotions caused by thinking about the event.

Arousal symptoms

Many people with ASD have problems with concentration, sleep, and emotional responses. They may be easily irritated and have strong reactions to stimuli such as loud noises. People with ASD may also experience physical symptoms of anxiety and hyper-arousal, such as headaches and gastrointestinal complaints.

Acute stress disorder causes

Acute stress disorder is thought to develop in part due to physiological reactions (such as rapid heart rate and release of stress hormones) at the time of the trauma. Memories of the trauma then trigger similar physical and psychological responses to those that occurred at the time of the event, leading to persistent symptoms.

Relation to PTSD

The symptoms of ASD are closely related to those of post-traumatic stress disorder (PTSD), but PTSD starts and/or lasts for more than a month after a traumatic event. Not everyone who has ASD will develop PTSD, and not everyone with PTSD has ASD first. Although ASD and PTSD are commonly discussed in connection with military combat, they also occur after other types of severe trauma:

  • Violent assault: Experiencing an act of severe physical or sexual violence often leads to ASD. The violence may be directly experienced, witnessed, or threatened.
  • Mass violence: Exposure to large-scale incidents of violence, including military combat or a mass shooting, may lead to ASD.
  • Sudden medical event: Most medical conditions are not considered possible triggers of trauma related disorders, but medical events that are sudden or life-threatening have been associated with ASD. Examples include miscarriages or severe injuries such as burns.
  • Natural disasters: Acute stress disorder can occur after exposure to a serious natural disaster, such as a hurricane or earthquake.
  • Violent or accidental death of another person: ASD may develop after the experience of learning about the sudden death of a close family member or friend.

Risk Factors

Any person who goes through a significant traumatic experience can develop ASD, but some features are associated with an increased risk. These include:

  • Previous trauma: People who have undergone serious trauma in the past are at increased risk for developing ASD after experiencing a new traumatic event.
  • Psychiatric history: People with pre-existing mental illness have an increased risk of developing ASD after experiencing a traumatic event.
  • Type of trauma: Although ASD can occur after any severe trauma, experiences that involve violence, such as sexual assault and mass shootings, are associated with particularly high rates of ASD. Those who experience medical events, accidents, or other types of trauma are less likely to develop the disorder.
  • Female gender: Acute stress disorder is more common among women than men.

Treatment options and prevention

Psychological treatment

Cognitive behavioral therapy (CBT) is often helpful for symptoms of ASD. CBT teaches strategies for dealing with unhealthy thought patterns and behaviors related to the trauma. For example, CBT might address a person's belief that they will never recover from the trauma. CBT also involves gradual exposure to memories of the event, allowing the person to decrease their emotional reactions and avoidance behaviors.

Psychiatric medications

In general, medications are not the first-line approach for ASD. Psychiatric medications such as antidepressants are more likely to be needed if the symptoms of ASD are long-lasting, progressing to PTSD. However, medications may be used to improve specific symptoms. A benzodiazepine, such as clonazepam (Klonopin) or alprazolam (Xanax), may be used briefly to help with sleep and anxiety.

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When shold I seek consultation for acute stress disorder?

If you are thinking of hurting yourself

Seek emergency psychiatric care if you are considering hurting or killing yourself at any time after a traumatic event.

If acute stress disorder symptoms are interfering with your life

The most important reason to seek help is if you have symptoms after a trauma that are interfering with your ability to function. Inability to enjoy daily activities, go to work, or spend time with family and friends without distressing symptoms are all signs that you should see a mental health professional. Prompt treatment of acute stress disorder lowers the risk that PTSD will develop.

If you are abusing substances

Use of excessive alcohol or illicit drugs to cope with symptoms of acute stress disorder is common but ultimately harmful. A medical provider can help you avoid substance dependence and access effective treatments.

If symptoms last more than a month

If more than a month has passed since the trauma and you are still experiencing acute stress disorder symptoms, or if you start experiencing symptoms after more than a month has passed, you may have PTSD. You should see a medical provider for diagnosis and treatment.

Questions your doctor may ask to determine acute stress disorder

  • Did you get hit in the head?
  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
  • Are you feeling irritable (easily made upset)?
  • Are you having difficulty concentrating or thinking through daily activities?
  • Are you experiencing a headache?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

Share your story
Once your story receives approval from our editors, it will exist on Buoy as a helpful resource for others who may experience something similar.
The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Dr. Le obtained his MD from Harvard Medical School and his BA from Harvard College. Before Buoy, his research focused on glioblastoma, a deadly form of brain cancer. Outside of work, Dr. Le enjoys cooking and struggling to run up-and-down the floor in an adult basketball league.

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