What is Acute Stress Disorder?

Acute Stress Disorder Explained: Signs, Diagnosis & Prevention

Acute stress disorder (ASD) may develop after exposure to a qualifying traumatic event, with symptoms lasting from three days to one month after the event. Symptoms can include intrusive memories, avoidance, negative mood, dissociation and heightened arousal.

What are the Causes of an Acute Stress Disorder? 

ASD can occur after a person directly experiences or witnesses a traumatic event or learns that a qualifying event happened to someone close to them. Traumatic events are characterised as those which are extremely stressful, distressing and frightening. Such events lead to helplessness and horror in individuals. Here are a few instances of events that can lead to ASD: 

• Death 
• Threat to the physical integrity of others or oneself 
• Threatened death or serious injury 
• The threat of an injury to others or oneself 
• Death threat to others 

Symptoms of Acute Stress Disorder 

People who have ASD experience symptoms that are similar to PTSD and other types of stress disorders. Generally, the symptoms of ASD can be categorised into the following five broad categories: 

• Intrusion Symptoms: Intrusion symptoms involve recurrent, involuntary, and distressing memories, dreams, or flashbacks related to the traumatic event.
• Avoidance Symptoms: People with ASD purposely avoid places, people, and situations that are related to the traumatic event in the past. 
• Negative Mood: There's a vast range of negative emotions that a person with ASD may go through, like low mood, sadness and negative thoughts in general. 
• Dissociative Symptoms: Having an altered sense of reality and a lack of awareness about present surroundings are also symptoms of ASD. 
• Arousal Symptoms: They can include sleep disturbances like insomnia, aggression or irritability. They can either be physical or verbal. 

Diagnosis of Acute Stress Disorder 

During a diagnosis of ASD, a doctor asks questions about the traumatic event and the symptoms of the person. A clinician evaluates exposure to trauma, symptom duration, impairment and the required diagnostic symptom threshold. 

When diagnosing, a doctor might also rule out any other possible causes of ASD: 

• Substance use 
• Underlying medical conditions 
• Other Psychiatric Disorders 

Treatment of Acute Stress Disorder 

A doctor works very closely with people who have ASD to develop a suitable treatment plan which meets individual needs. The treatment for ASD also focuses on reducing symptoms and improving coping mechanisms, thus preventing PTSD. Here are a few treatment options for ASD: 

• Trauma-focused cognitive behavioural therapy (CBT): Doctors can recommend CBT as a first line of treatment for people who have ASD. It involves working with a mental health professional who can help the patient develop coping strategies. 
• Mindfulness: These interventions teach ways and techniques to manage stress along with anxiety. It can include breathing and meditation exercises. 
• Medications: Medications such as antidepressants (e.g., SSRIs) may be used to manage specific symptoms. Pharmacological treatment is not first-line and is considered based on individual needs. 

Self-Care for Acute Stress Disorder

The following activities may help you to take care of yourself, cope and support your recovery from acute stress disorder: 

1. Prioritise professional help, such as trauma-focused therapy. 
2. Practice healthy self-care by maintaining a balanced diet. 
3. Get 7-8 hours of quality sleep. 
4. Engage in creative activities such as art, music, etc. 
5. Exercise regularly to help reduce stress and enhance mood. 
6. Avoid tobacco products. 
7. Limit alcohol consumption. 
8. Make social connections with your family or friends. 
9. Go for counselling sessions and follow-up visits. 
10. Speak with trusted friends or family members when you need support. 
11. Drink plenty of water to stay hydrated. 

Prevention of Acute Stress Disorder 

Not all traumatic events can be prevented, but timely support may help reduce distress after an event. However, there are several ways to decrease the risk of developing an ASD after experiencing a traumatic event: 

• Seeking mental health support from a professional. 
• Getting treatment for other mental health disorders. 
• Training programs in high-risk professions may improve preparedness and coping skills but do not guarantee prevention of ASD. 
• Getting support from friends and family. 

ASD is not an uncommon condition. However, it is recommended to get treatment for it at the earliest to prevent it from further developing into PTSD (Post Traumatic Stress Disorder), as they are more long-term when compared to ASD. 

Effects of ASD on Everyday Life 

The effects of ASD vary across different aspects of an affected person, like physical health, emotional state, behavioural changes and interpersonal relationships. Here is an overview of them: 

• Digestive Issues: Having acute stress can have a great impact on a person's digestion and could lead to digestive issues. For instance, there can be drastic changes in bowel movements, like constipation or diarrhoea. It can also exacerbate existing digestive conditions in some people.
• Sleep Disturbances: Acute stress can disrupt sleep. It can disrupt a person's restful sleep by manifesting as frequent awakenings, sleepwalking, insomnia or even nightmares about the traumatic event. 
• Depression and Anxiety: ASD, if not resolved, can lead to a person experiencing depression and anxiety. It involves a significant amount of fear, helplessness, and potentially re-experiencing the trauma through memories and flashbacks. 
• Increased Risk of Chronic Diseases: Persistent stress may affect physical health, but claims about specific long-term diseases should be supported by evidence. These include mental health conditions, cardiovascular problems and digestive issues. It can also lead to other health issues like metabolic syndrome, obesity, arthritis and type II diabetes. 
• Mood Swings: People with ASD experience extreme mood swings. There is a persistent feeling of sadness, despair, hopelessness or a loss of interest in activities. It is also common to have a lapse in memory due to an active effort on the part of the affected person to repress the traumatic event. 
• Relationship Difficulties: An acute stress disorder can make a person feel numb, emotionally unresponsive and numb to interpersonal relationships. These people create distance from everyone and avoid any kind of engagement or social interaction with other people. A communication gap like this creates strain on relationships with family, friends, workmates, etc. 
• Social Withdrawal: Avoidance of social situations and people is a significant symptom of Acute Stress Disorder (ASD). This kind of withdrawal is a temporary coping mechanism and leads to loneliness and psychological distress. 
• Difficulty in Concentrating: After experiencing a traumatic event, it can become difficult to concentrate on normal, day-to-day tasks. Additionally, a person can also feel irritable with everyone and everything. 

How Does ASD Affect Individuals in the Long Term? 

Some people with ASD later develop post-traumatic stress disorder (PTSD), but many do not. When trauma-related symptoms continue beyond a month, a clinician may assess whether the criteria for PTSD are met. In this situation, getting treatment for it reduces the chances of developing PTSD. 

To cope with ASD, it is important to prioritise self-care and safety and seek support. Furthermore, maintaining a healthy lifestyle by exercising, having a balanced diet and getting sufficient rest during this time becomes vital. 

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