Acute Stress Disorder Vs. PTSD: What Is the Difference?

What Is Acute Stress Disorder?

Acute stress disorder is a stress response that can occur after exposure to traumatic events, such as death, serious injury, or sexual assault.¹ This condition is prevalent in professions that provide direct care and support, including social work, counseling, and law enforcement. Individuals can also develop acute stress disorder after hearing details about or witnessing trauma.^{1, 2, 3}

Symptoms of acute stress disorder may include:

• Recurrent distressing memories
• Dissociation
• Psychological or physical distress to reminders of the traumatic event(s)
• Inability to experience positive emotions
• Feeling dazed or “zoned out”
• Avoidance behavior
• Difficulty falling and/or staying asleep
• Becoming more easily startled
• Hypervigilance

What Is PTSD?

Similar to acute stress disorder, post-traumatic stress disorder (PTSD) can develop after experiencing or witnessing trauma. Symptoms of PTSD vary from person to person but are persistent, lasting longer than four weeks. Trauma survivors often struggle with daily functioning due to their symptoms, as accompanying flashbacks, anxiety, and nightmares can make even routine behavior difficult.

Symptoms of PTSD may include:

• Involuntary, recurrent, distressing memories related to the traumatic event
• Reliving of the trauma
• Intense body/mind reactions to external or internal reminders of trauma
• Active and persistent avoidance of reminders of the trauma
• Persistent negative changes in mood and thoughts
• Inability to remember part or all of the traumatic event(s)
• Distressing negative beliefs about oneself, others, and/or the world
• Loss of interest in previously enjoyed activities
• Social isolation
• Irritability, anger, and/or aggressive outbursts
• Engaging in self-destructive or high-risk behaviors
• Startling more easily
• Poor concentration
• Sleep problems

Acute Stress Disorder Vs. PTSD: What Is the Difference?

Acute stress disorder and PTSD are both responses to traumatic events that share many symptoms. However, the most obvious difference between acute stress disorder and PTSD is symptom duration. Additionally, the onset and type of symptoms vary between the two conditions, as PTSD can develop years after an event, whereas acute stress disorder is immediate.

Acute Stress Disorder Vs. PTSD: Are They Similar?

Acute stress disorder and PTSD both occur in response to trauma exposure. These conditions overlap in many ways, with symptoms leading to difficulties in one or more areas of life (e.g., work/school, social life, family). Trauma survivors, regardless of this diagnosis, often experience mood disturbances, intrusive memories, difficulties sleeping, and heightened anxiety.

Similar symptoms between acute stress disorder and PTSD include:¹

• Recurrent distressing memories, dreams, or flashbacks
• Intense psychological/physical distress to trauma triggers
• An inability to experience positive emotions
• An inability to remember all or parts of the traumatic event(s)
• Actively trying to avoid trauma reminders
• Increased irritability and anger
• Difficulty relaxing
• Exaggerated startle response
• Sleep issues
• Concentration problems

When Does Acute Stress Disorder Become PTSD?

For the majority of those with acute stress disorder, symptoms resolve within four weeks following the trauma. However, this condition can develop into PTSD for several reasons. For example, experiencing additional stress after a traumatic event can exacerbate symptoms.

Additionally, adopting maladaptive coping skills can impede the ability to heal from trauma and contribute to diagnosable PTSD. In other cases, individuals may hold negative interpretations of the event, their responses, or the aftermath, possibly affecting their self-esteem and confidence when recovering.⁴

Complications of Acute Stress Disorder & PTSD

Acute stress disorder and PTSD can both lead to significant distress and impairment in daily life. These conditions can occur on a spectrum, with ASD appearing before PTSD and potentially progressing to PTSD if symptoms. PTSD has a greater risk of long-lasting, significant complications due to the chronic and severe nature of the symptoms.

Below are possible complications of untreated acute stress disorder and PTSD:

• Relationship difficulties: Symptoms can create problems in social interactions and relationships due to avoidance, isolation, and conflict.
• Self-harm: Individuals who have suffered a traumatic event have a higher risk of self-harming behaviors.
• Increased risk of suicidal ideation: PTSD carries an increased risk of feelings of hopelessness, suicidal thoughts, and suicide attempts.
• ASD progression to PTSD: If not treated early, acute stress disorder can progress to PTSD and cause more severe and difficult-to-treat symptoms.
• Job loss: Trauma can impact the ability to perform at work or school, leading to job loss or academic problems.
• Increased risk for substance abuse: Some individuals may turn to drugs or alcohol to cope with trauma-related symptoms.

Treatment for Acute Stress Disorder & PTSD

Untreated trauma can affect your life in many ways. While healing from trauma can sound scary, support is available to assist you as you develop healthier coping skills. When finding the right therapist, consider locating providers specializing in trauma therapy. These professionals understand the varying degrees and nature of trauma disorders, including PTSD and acute stress disorder.

Becket-Davenport encourages, “People need space to process their traumatic event in the days and weeks following the trauma. However, this does not mean they should be pushed to retell or relive the event. Rather, people should have the opportunity to talk about how they feel and how they felt during the event. This can be helpful for recovery.”⁸

Treatment for acute stress disorder and PTSD may include:

• Cognitive processing therapy (CPT): CPT helps by addressing and modifying negative beliefs related to the traumatic event.
• Trauma-focused CBT: TF-CBT is a specific trauma-informed therapy. This approach integrates CBT with trauma-focused treatment to provide psychoeducation, processing, and coping skills.
• Eye movement desensitization and reprocessing (EMDR): EMDR involves guided eye movements to evoke trauma-related memories. The client and therapist work to process these experiences to facilitate healing and coping.
• Medications: A healthcare provider can prescribe anti-depressants and anti-anxiety medications as part of treatment. Medications can stabilize mood, reduce symptoms, improve sleep, and improve therapeutic outcomes.
• Cognitive behavioral therapy (CBT): CBT works by helping individuals identify the negative thoughts that contribute to their feelings of distress. They can then challenge and modify these thoughts, leading to healthier and more adaptive behaviors.
• Narrative therapy: Narrative therapy focuses on identifying and changing the stories a person tells themself about their experiences. Some techniques include externalizing the problem, identifying moments of resilience or strength, and re-writing the story to be one of survival.
• Accelerated resolution therapy (ART): ART also uses eye movement similar to EMDR but focuses on replacing distressing memories.
• Prolonged exposure: This therapy exposes individuals to thoughts, emotions, and memories to desensitize distressing material.

How to Cope With Acute Stress Disorder & PTSD

Coping with acute stress disorder and PTSD is specific to individual experiences, symptoms, and needs. Coping strategies can help reduce the impact of symptoms, prevent acute stress disorder from progressing into PTSD, and support a person in their recovery as they heal from their trauma.

Below are healthy ways to cope with acute stress disorder and PTSD:

• Prioritize self-care: Engage in activities that foster rest, relaxation, and self-care. Healthy options include getting good sleep, eating healthy, exercising, or making time for hobbies you enjoy.
• Set healthy boundaries: Healing from trauma can be exhausting. However, setting boundaries can help you reduce or avoid exposure to triggering memories and protect your peace.
• Re-evaluate your relationships: Examine your relationships and how they make you feel. Do you feel supported, understood, and respected? Consider leaving relationships that make you feel drained or unappreciated.
• Get professional help: Working with a trained mental health professional for therapy or medication is a step toward caring for yourself and building healthy coping skills.
• Practice mindfulness: Mindfulness is a powerful self-care tool that helps you stay in the current moment without judgment. These practices can reduce stress and support emotional well-being.
• Reduce stress level: Many trauma symptoms can worsen when individuals allow them to continue. Maintaining lower stress levels is a crucial part of healing.
• Practice self-compassion: Remember, you have been through a lot. Offer yourself the same compassion, empathy, and kindness as you would a good friend. Permit yourself to take the time you need to get better.