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Acute Stress Disorder vs PTSD

Katelyn Hagerty

Reviewed by Katelyn Hagerty, FNP

Written by Our Editorial Team

Published 04/13/2022

Updated 04/14/2022

Navigating the waters of post-traumatic stress disorder (PTSD) can seem daunting, but learning more about this disorder can drastically improve your ability to cope with it. If you’re just starting to dig into PTSD one phrase you’ll keep seeing pop up is “acute stress disorder.” But what is acute stress disorder vs. PTSD?

Are they one in the same? Are they similar? What differentiates the two? 

All these questions are important to ask, and having a better grip on what both ASD and PTSD are will only help you in the long run. 

Think of acute stress disorder as a precursor to posttraumatic stress disorder. It’s still a psychological disorder like PTSD, but it develops within four weeks of experiencing traumatic or stressful events.

It’s thought that within one month of trauma, between six percent and 33 percent of people develop it, but the statistics regarding who experiences ASD vary, namely based on what appears to be the type of traumatic experience.

For example, survivors of natural disasters like typhoons seem to have a lower rate of developing it, while survivors of sexual assaults develop it at a higher rate.

Physical Symptoms of Acute Stress Disorder

A common symptom of acute stress disorder is not knowing where you are or feeling outside of your body. 

A healthcare professional has to diagnose acute stress disorder. To be diagnosed, you’ll need to have at least nine of the following physical symptoms for at least three days for up to one month: 

  • Extreme responses to things like loud noises, sudden movement or other stimuli 

  • Recurring distressing memories of the trauma 

  • Intense psychological distress when reminded of traumatic events

  • Flashbacks

  • Recurring distressing dreams about the trauma 

  • Inability to experience positive emotions

  • Trouble concentrating

  • Altered sense of reality or dissociative symptoms

  • Avoiding reminders of the trauma

  • Making an effort to avoid distressing memories

  • Difficulty sleeping

  • Memory loss around the traumatic event

  • Irritability or angry outbursts

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But what if extreme distress continues for longer than a month following a traumatic incident? That may be post-traumatic stress disorder. 

A surprisingly large number of people experience PTSD — it’s thought to be around 9 million people in the United States. Of those, about 37 percent of people experience severe symptoms. 

Women are two to three times more likely to develop PTSD than men.

Not everyone who goes through a traumatic event will develop PTSD. If someone receives social support, it may prevent PTSD from developing. On the flip side, stress can increase the chance of it developing.

While acute stress disorder pops up within the first four weeks following a traumatic event, PTSD tends to pop up within the first three months. However, it can also emerge years later.

Symptoms of PTSD

It’s worth noting that women may experience PTSD symptoms differently than men. In A 2015 study, it was found that women experience more distress than men in almost all PTSD symptoms. 

Here are some of the most common PTSD symptoms: 

  • Re-experiencing the trauma: A re-experiencing symptom can look like a number of things. For example, say you spot someone who looks like the person that assaulted you and feel the same intense fear you did while being harmed. Flashbacks, nightmares and intrusive memories are also ways this type of symptom manifests.

  • Avoidance: Avoiding anything that may remind you of your trauma is also a symptom. This can mean physical places or thoughts or feelings related to what happened. Research has found that this is one of the most common symptoms that women with PTSD experience.

  • Cognition and mood symptoms: Dissociation and numbness are also common feelings. Some people have difficulty remembering the trauma, while others blame themselves for whatever happened. Trouble concentrating, anger and no longer being able to enjoy things you once enjoyed can also occur.

  • Arousal symptoms: Hypervigilance is considered an arousal symptom, as is startling easily, difficulty sleeping and emotional outbursts.

While technically different disorders, there’s some overlap in treatment for ASD and PTSD. Therapy is suggested for both (more on that below), while medication tends to be reserved for PTSD, though it’s not impossible that someone experiencing ASD may be given medication. 

Therapy

Cognitive behavioral therapy (CBT) has been found to be a promising method in the treatment of both ASD and PTSD. In CBT, a person works to call out harmful or negative thought patterns and come up with ways to change them. Within CBT, there are two formats that are commonly used in ASD and PTSD treatment. They are:

  • Exposure Therapy: You’ll face your fears by exposing yourself to your the thing that triggers your trauma response. This may happen through recounting the trauma or even going to the place it happened. 

  • Cognitive Restructuring: Here, you restructure your memory of your trauma by looking at the facts to gain perspective. This is helpful because people who experience trauma often remember it differently from how it actually happened or try to repress it completely. 

Our blog on therapy for PTSD gives more details on this treatment form.

Eye Movement Desensitization and Reprocessing (EMDR)

While not so much used for acute stress disorder, EMDR is used for PTSD. 

In EMDR, you’ll be asked to focus on the trauma that caused your PTSD. At the same time, you’ll engage in bilateral stimulation (often eye movements). The thinking is that this lowers the emotional response to memories of the trauma.

Medication

Generally, medication isn’t prescribed for acute stress disorder in adults (or anyone, really), as it’s typically an ineffective method. However, an antidepressant may be used to treat PTSD. 

While they don’t cure PTSD, they can help reduce emotional distress associated with it — like sadness, worry, and anger. 

Medication is often prescribed in conjunction with therapy. Antidepressants sometimes used to treat PTSD include sertraline, paroxetine, fluoxetine, venlafaxine.

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A traumatic event — military personnel who see combat, someone in a car accident, someone who survives a violent act or natural disaster — can have a massive impact on one’s mental health. Sometimes people even develop mental health conditions that need to be addressed. 

If you experience things like flashbacks, recurring memories of the trauma or intense psychological distress, you may be dealing with acute stress disorder. This disorder only pertains to the first four weeks after a traumatic incident. If psychological stress persists past the first month, you may be dealing with posttraumatic stress disorder. 

There are a few effective treatments for ASD and PTSD. Online therapy can be used in the treatment of patients with both mental disorders. Medication is also sometimes introduced to deal with PTSD. 

To determine if you are dealing with either of these conditions or if you would like help seeking treatment, you should schedule an online psychiatry consultation with a mental health provider. 

11 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Posttraumatic Stress Disorder. National Alliance on Mental Illness. Retrieved from https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Posttraumatic-Stress-Disorder
  2. Acute Stress Disorder. U.S. Department of Veterans Affairs. Retrieved from https://www.ptsd.va.gov/understand/related/acute_stress.asp
  3. Barnhill, J., (2020). Acute Stress Disorder. Merck Manual. Retrieved from https://www.merckmanuals.com/home/mental-health-disorders/anxiety-and-stress-related-disorders/acute-stress-disorder
  4. Olff, M., (2017). Sex and gender differences in post-traumatic stress disorder: an update. European Journal of Psychotraumatology. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632782/
  5. PTSD Basics. U.S. Department of Veterans Affairs. Retrieved from https://www.ptsd.va.gov/understand/what/ptsd_basics.asp
  6. Post-Traumatic Stress Disorder. National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd
  7. Hourani, L., Williams, J., Bray, R., Kandel, D., (2015). Gender differences in the expression of PTSD symptoms among active duty military personnel. Journal of Anxiety Disorders. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S088761851400173X?via%3Dihub
  8. Post-Traumatic Stress Disorder. Medline Plus. Retrieved from https://medlineplus.gov/posttraumaticstressdisorder.html
  9. Treatment and Facts: Post-Traumatic Stress Disorder. Anxiety and Depression Association of America. Retrieved from https://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd/treatment-facts
  10. PTSD Treatments. American Psychological Association. Retrieved from https://www.apa.org/ptsd-guideline/treatments
  11. Fanai, M., Khan, M., (2021). Acute Stress Disorder. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK560815/

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Katelyn Hagerty, FNP

Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.

She received her undergraduate degree in nursing from the University of Delaware and her master's degree from Thomas Jefferson University. You can find Katelyn on Doximity for more information.

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