Acute Stress Disorder

Introduction

Acute Stress Disorder is an anxiety disorder that occurs often in the wake of traumatic or life-threatening events. It is characterized by symptoms such as nightmares, distressing memories, and emotional numbing. Acute stress disorder has many symptoms and characteristics in common with post-traumatic stress disorder (PTSD). However,  acute stress disorder typically fades within one month of the traumatic event, while PTSD lingers. 

Between 6% and 30% of the population has experienced acute stress disorder at some point. In this comprehensive guide, we will discuss the causes and symptoms of acute stress disorder, as well as treatment and prevention options.

causes

After a traumatic event, acute stress disorder can occur as a psychological response. The mind stays in a tense “survival mode” to protect the body, even though the danger has passed. This is most common with life threatening experiences, serious injury, or sexual violence. Additionally, prevalence of acute stress disorder is often lower in cases such as car accidents and higher in traumatic events such as mass shootings. Some contributing factors of acute stress disorder include:

1. Traumatic Events: Trauma is the leading cause of acute stress disorder. This may include: accidents, natural disasters, physical assault, sexual assault, terrorism, combat, sudden loss of a loved one, mass shootings, or a life-threatening medical diagnosis. 
2. Perceived Threat: In some cases, the event that triggered acute stress disorder was not actually threatening but the perceived threat can be enough to cause acute stress disorder. For instance, if a bank or storefront is robbed by someone pretending to be armed, that event can be traumatizing even if it is later learned that the robber was not armed. 
3. Personal Vulnerabilities: Everyone has their own vulnerabilities. If you have a personal history of trauma or anxiety disorders, or if your family medical history has a record of anxiety disorders, you may be more susceptible to acute stress disorder.
4. Lack of Social Support: A lack of a support system is another vulnerability factor. Support systems can help you to heal and feel safe after a traumatic event. Without social support, you may go into survival mode partially out of feeling isolated.
5. Intense Emotional Responses: After a traumatic, life-threatening event, people often feel fear, grief, helplessness, or anger. These intense feelings can sometimes trigger acute stress disorder as a way to protect you from the pain.
6. Neurobiological Factors: Neurobiological factors such as the presence of stress hormones in the body or an overactive nervous system, can all impact the likelihood of developing acute stress disorder. 
7. Cognitive Factors: The way that people respond to trauma is often informed by their preconceived beliefs and thought patterns. Negative thought patterns and distorted beliefs can impact trauma and therefore acute stress disorder. 
8. Avoidance Behaviors: Emotional avoidance can sometimes enhance acute stress disorder. Emotional avoidance is used to avoid painful feelings and the processing of painful experiences. That avoidance gets in the way of healing.

symptoms

Acute stress disorder symptoms typically manifest within the month following the triggering event. They may last anywhere between two days and four weeks. If symptoms persist beyond that month, you should speak with a mental health professional about consideration for a PTSD diagnosis. 

Symptoms for acute stress disorder include:

• Dissociation: a state of emotional numbness and detachment from reality, feeling dazed or far away
• Re-experiencing the traumatic event — in the form of distressing memories, nightmares, or flashbacks
• Avoidance of places, sensations, and individuals that bring to mind the traumatic event
• Anxious or distressed feelings even when there is no imminent threat
• Intense feelings of fear or helplessness, sometimes leading to depressive episodes

Symptoms of acute stress disorder can disrupt your ability to work, connect with others, or perform daily tasks. When neglected, they can worsen, developing into PTSD. This is why it’s important to speak with a psychiatrist as soon as possible.

diagnosis

The path to an acute stress disorder diagnosis begins with a psychiatric evaluation of your medical history and symptoms. Open communication is key regarding the triggering event and all of your symptoms. After structured assessments, the psychiatrist compares your symptoms with diagnostic criteria for acute stress disorder, as well as any concurrent conditions. Once diagnosed, you and your psychiatrist can begin mapping out a tailored treatment plan. You can start today by finding a mental health provider with Rivia Mind and booking a free 15-minute consultation.

treatment

Acute stress disorder is very treatable, and you have a number of treatment options. In most cases, your mental health provider will suggest a combination of multiple treatments. The goal is to alleviate your symptoms and prevent the development of PTSD. Some treatments for acute stress disorder include: 

1. Psychotherapy:
   • Cognitive-Behavioral Therapy (CBT): This evidence-based therapy is the first type of psychotherapy typically used in cases of acute stress disorder. CBT works by helping patients process traumatic experiences and challenge their negative thought patterns to change behaviors. CBT will sometimes involve exposure therapy in which you gradually intentionally pre-process traumatic memories to reduce distress.
   • Trauma-Focused CBT: Trauma-focused CBT takes the principles of CBT but works from the basis of trauma. This therapy helps patients to develop coping strategies and manage their distress. 
   • Eye Movement Desensitization and Reprocessing (EMDR): In EMDR, patients learn to reprocess their traumatic memories while going through repetitive eye movements or bilateral tapping in order to reduce distress. 
2. Medications:
   • Antidepressants: Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) may be prescribed to manage symptoms of anxiety, depression, and hyperarousal commonly associated with acute stress disorder.
3. Supportive Interventions:
   • Psychoeducation: Mental health providers can provide you with resources and education to gain a better understanding of acute stress disorder so that you feel more prepared to handle your symptoms.
   • Counseling: Counseling allows patients with acute stress disorder to have a safe place to talk about their emotional symptoms and develop coping strategies. 
4. Stress Management Techniques:
   • Relaxation Techniques: A mental health professional may recommend relaxation techniques such as breathing techniques, muscle relaxation, and grounding techniques to help you come down from moments of distress. 
   • Mindfulness: Mindfulness techniques help you to stay in the present moment, aware of your feelings and the environment around you, reducing dissociation and emotional avoidance. 
5. Social Support:
   • Acute stress disorder can feel very isolating, so it may be helpful to connect with loved ones such as close friends or family during this time. 
6. Self-Care:
   • Maintaining a healthy lifestyle including exercise, a balanced diet, and healthy sleep can contribute to overall well-being and stress reduction.

Acute stress disorder varies from individual to individual. It’s important to be open and honest with your mental health professional so they can develop a tailored treatment plan that will be effective in helping you manage your symptoms and heal.

prevention

You may not be able to prevent traumatic events, but you can take proactive steps to manage your stress and prevent acute distress disorder. A few strategies that may help you to build resilience and reduce the risk of developing stress disorders after a traumatic event include: 

1. Relaxation and Mindfulness:
   • Emotional management techniques such as mindfulness and relaxation skills can be used as treatment for acute stress disorder, but they can also help you build up a resilience to prevent acute distress disorder. 
2. Social Support:
   • Developing a strong social support network of friends, family, and people you can turn to in times of distress can help offer you armor when the unexpected happens. 
3. Education:
   • Understanding emotion regulation, stress, and how to cope with stress can help you to better be prepared to cope with triggering events when they occur.
4. Develop Coping Skills:
   • Build your problem solving, positive thinking, and emotion regulation strategies to help you manage and reduce distress.
5. Healthy Lifestyle:
   • Maintaining a healthy lifestyle with regular exercise, a balanced diet, and sufficient sleep contributes to your holistic health, including stress management.
6. Safety Measures:
   • Always practice personal safety measures and traffic safety measures to reduce the risk of traumatic events to begin with.
7. Establish a Routine:
   • By developing a routine, you establish a sense of normalcy that can help you to cope after a traumatic event.
8. Conflict Resolution:
   • Some triggering events can be interpersonal conflicts. Learning conflict resolution skills can help you to reduce the risk of interpersonal conflicts growing out of control.
9. Early Intervention:
   • Seeking professional help and support early after a traumatic event can prevent the escalation of symptoms and the development of ASD.
10. Support from Professionals:
    • If you have a history of trauma or are exposed to high-stress environments, consulting with mental health professionals can provide guidance on coping strategies and prevention.

Keep in mind that even if you do all the preparation you can to prevent acute stress disorder, traumatic events may still happen and cause acute stress disorder. It is never your fault when you develop acute stress disorder. Speak with a mental health provider at Rivia Mind in the aftermath of a traumatic event to help you prevent or manage acute stress disorder.

anatomy

Understanding the body’s stress response and its connection with your brain’s structure and function can help you better understand physical manifestations of acute stress disorder. This knowledge can be empowering in the journey towards healing and recovery.

Acute stress disorder has been linked with overactive right amygdala and prefrontal cortices. These parts of the brain are important when it comes to processing fear. When overactive, they cause you to be in an extended state of fear, even after you are out of danger. Cortisol levels also tend to increase, exacerbating feelings of stress. This increase in mental activity can be both mentally and physically exhausting, sometimes leading to feelings of lethargy or depression, as well as agitation.

Am I at Risk

Risk for acute stress disorder hinges on a number of factors, including:

• Personal vulnerability factors
• History of trauma
• Family medical history

Unsure if you’re at risk for acute stress disorder? The best thing to do is to contact a mental health professional for an assessment after a traumatic event.

complications

Acute stress disorder has comorbidities with other conditions, especially when untreated. Feelings of helplessness and isolation can lead to depressive episodes. The high anxiety that comes with acute stress disorder can also exacerbate other existing anxiety disorders, such as social anxiety or generalized anxiety disorder (GAD). If you have already been diagnosed with these conditions, it may increase your risk of acute stress disorder. Acute stress disorder can also increase the risk of these conditions for you.

advancements

Fortunately, advancements in psychological research and therapeutic techniques have shown promise in treating, managing, and even preventing acute stress disorder. Innovative interventions, including virtual reality exposure therapy and neurofeedback, are being explored for their potential efficacy in addressing acute stress disorder symptoms.