Acute Stress Disorder: Symptoms, Causes, and Treatment

These days, we’re better at spotting trauma and stress responses, and depending on how and when they happen, they’ll go by different names.

You may have heard (and used) the term post-traumatic stress disorder to describe symptoms of distress after a traumatic experience. But you may be suffering from a different condition, like acute stress disorder.

But what is acute stress disorder? How does it differ from post-traumatic stress disorder? Are there any telltale signs or markers to look out for? How is acute stress disorder treated? 

There’s a lot to unpack here, so let’s start at the beginning.

Acute stress disorder (ASD) is a relatively new diagnosis within the larger group of stress disorders, including the more well-known posttraumatic stress disorder, or PTSD.

Conveniently, it’s best to explain ASD in comparison with PTSD because, well, that’s how experts see it.

ASD was first identified in 1994 as a particular trauma or acute stress reaction taking place in a specific window of time following a traumatic or stressful event. Posttraumatic stress disorder represents stress disorders that begin to take shape weeks or months after an event — a good example of this might be a person who begins to have nightmares months after surviving an assault.

Acute stress disorder, by contrast, fills the space from just a few days after the traumatic event up to one month after the event has taken place — a relatively short term by mental health standards.

With acute stress disorder, the trauma response and its symptoms are essentially active after the immediate danger has passed.

For military personnel, for instance, that means the period immediately following combat. You may no longer be in a fight-or-flight situation, but nevertheless, your fight-or-flight instinct remains activated. 

And that activation comes with symptoms.

Telling whether you or a loved one has the signs of acute stress disorder can be difficult, and signals aren’t always easily spotted. 

Someone’s entire personality may change drastically if they’re suffering from acute stress disorder, but they may likewise experience imperceptible changes or mask them extremely well as a coping mechanism.

Symptoms of acute stress disorder are organized into five categories outlined by the American Psychiatric Association:

Negative Mood

While negative mood is a common symptom of mental disorders, in regard to ASD, it’s another clear marker that (in association with the others on this list) you might indeed be suffering from a stress disorder. 

If this is the only marker you’re seeing, it’s still worth talking to a mental health professional, as negative mood (the inability to feel love, happiness or a sense of success) is associated with depression, anxiety and more.

Avoidance

Avoidance of reminders of trauma can actually mean a lot of things, whether it’s taking a different route to avoid the site of traumatic traffic accidents or developing dissociative amnesia to protect one’s mind from details of child abuse. 

While it’s normal to assume that it will correspond with the source of trauma, someone experiencing avoidance symptoms will avoid thoughts about the trauma, distressing memories of the trauma and/or feelings related to the trauma, as well as any people, places or things that may remind them of trauma.

Dissociation

Dissociative symptoms are all about emotional detachment — when you detach from reality, experience amnesia about events or feel distant or unattached to your own experiences and emotions, it’s a sign of dissociative disorders or behaviors.

To learn more about this, read our blog on Anxiety & Dissociation.

Intrusion

Intrusion is a familiar set of symptoms to people with mood disorders. 

These symptoms can include flashbacks, distressing dreams and recurring thoughts or intrusive memories about distressing or traumatic events of the past. 

Intrusive thoughts that result in distress mentally or physiologically are clear examples of intrusion.

Arousal

Arousal doesn’t mean what you’d rightly assume it means — there’s no sexual symptom of ASD. Rather, this category points to symptoms that mark a predisposition to reacting in extremes. 

Arousal symptoms include sleep problems like insomnia, irritability, angry outbursts, rage with minimal provocation, distractibility, high alertness to surroundings and unusually strong reflexive reactions to sudden events.

While acute stress disorder may seem like a fairly rare condition, it’s actually pretty common to experience extreme stress. Some studies suggest that as much as 90 percent of the population will be exposed to an extremely stressful event in their lifetime.

That said, the population of people who convert that event into a long-term disorder is likely much smaller — between one percent and 11 percent of the population will extend those symptoms of disorder beyond the ASD criteria and enter into medical conditions like posttraumatic stress disorder, which account for much longer periods of psychological distress.

Your risk factor for developing ASD is difficult to explain, in part because the existence of ASD as a known condition is so new. 

But many experts point to the risk factors of posttraumatic stress disorder as close enough in resemblance. These are typically broken into three categories: pretrauma, peritrauma and posttrauma.

Pretrauma Factors

Pretrauma factors are the ones that make you more at risk of disorder before trauma even happens. According to the National Library of Medicine, the following factors increase your risk of ASD and PTSD before trauma happens:

• Genetics

• Personality Disorders

• History of Trauma

• History of Psychiatric Disorder

• Lack of Education

• Intellectual Disability

• Female Gender

Peritrauma Factors

Peritrauma risk factors increase the likelihood of disorder from a traumatic event during the traumatic event itself. They include:

• The Severity of the Trauma

• Physical Injury During the Trauma

• Sexual Violation, Rape or Other Sexual Assaults

Posttraumatic Factors

Posttraumatic factors are what increase your likelihood of experiencing ASD or PTSD after the trauma has taken place. If any of the following occur, you can reasonably assume your chance of stress disorder has increased:

• Brain Injury

• Disability

• Dissociative Symptoms

• Poor Socioeconomic Status

• Severity of Physical Symptoms Like Physical Pain

• Existing ASD

• Life Stress Severity

• ICU Stays

Treating acute stress disorder looks remarkably like the treatment process for other mental health issues, and that’s because, at the end of the day, it responds to the same methods of treatment: therapy and medication.

Psychotherapy is remarkably effective when it comes to trauma, and a trauma-focused form of cognitive-behavioral therapy (also known as CBT) can help you learn to identify trauma responses in your behaviors and begin to work through the triggers, the responses and the solutions to control those problems.

In certain cases, CBT and cognitive restructuring can also reduce your risk of acute stress disorder turning into posttraumatic stress disorder.

A mental health professional might also recommend exposure therapy — a particular kind of CBT that helps you build a tolerance for the triggering thoughts, situations and events that can overwhelm people after trauma.

Exposure therapy can temporarily increase stress and temporarily worsen symptoms, so this is a treatment best carried out by a professional.

Medication may also be beneficial to people with ASD, and a variety of medications like antipsychotics, selective serotonin reuptake inhibitors (SSRIs) and antidepressants like benzodiazepines can also offer symptom relief and mood moderation for people who need some extra help.

Ultimately, a healthcare provider or mental health professional will help you make the final call on the best course or courses of treatment for your individual condition. 

Stress disorders are unique from person to person, and that expert support is the key to finding the right treatment for your desired outcome.

Coping with trauma and extreme levels of stress is not something you should do alone. It’s not a process as simple as replacing negative feelings with positive emotions.

While many cultures the world over value strength, perseverance, and other traits highly, the reality is that many of the struggles we deal with day in and day out are best addressed with help. 

If you’re struggling today, get the help you need. Seek out therapy for treating anxiety, and consider using our other mental health resources.

Unpacking trauma isn’t an overnight process, but you can start the journey before the next sunrise. Do it today.