Acute Stress Disorder: Symptoms, Causes, & Treatment

What Is Acute Stress Disorder?

Acute stress disorder (ASD) is a short-term condition that develops within a month of experiencing trauma, such as an accident, injury, or assault. Symptoms of acute stress disorder can leave individuals feeling anxious, helpless, or emotionally numb. Early intervention is crucial to prevent ASD from worsening and progressing.

Acute Stress Disorder Vs. PTSD

Acute stress disorder resembles post-traumatic stress disorder (PTSD) but differs slightly. Physicians diagnose ASD when symptoms occur within three to 30 days following trauma, while PTSD persists beyond a month.

Moreover, PTSD includes behavioral and non-fear-based symptoms, such as negative self-talk and self-blame. Those with PTSD also often report feeling detached or dissociated from their bodies and surroundings. These symptoms do not commonly accompany ASD.

Acute Stress Disorder Vs. Adjustment Disorder

Both ASD and adjustment disorder reflect a response to stress or trauma. However, ASD typically occurs after an extremely traumatic event, while adjustment disorder can result from more common life stressors.

For example, individuals may experience adjustment disorder after a job loss, divorce, or illness, whereas ASD develops after events like assault, witnessing death, or surviving a disaster. Adjustment disorder symptoms are often less invasive, long-lasting, and life-altering than those associated with acute stress disorder.

How Common Is Acute Stress Disorder?

Many may not seek treatment after a traumatic experience, which makes pinpointing the exact number of people with acute stress disorder impossible. However, some studies suggest that 19% of trauma survivors experience ASD, with 80% later developing PTSD.^1,2,3

Acute Stress Disorder Symptoms

Common symptoms of acute stress disorder include intrusive thoughts or memories related to the traumatic event, often referred to as flashbacks. These experiences can be distressing and cause the individual to relive the event. Individuals with ASD may also have nightmares and emotional numbness. This stress can contribute to difficulty sleeping, irritability, and avoidance of people or situations that trigger trauma memories.

Below are common symptoms of acute stress disorder:

• Recurring, uncontrollable, and distressing memories of the event
• Recurrent nightmares of the event
• Flashbacks
• Intense psychological or physical distress when reminded of the event
• Persistent inability to experience positive emotions
• An altered sense of reality (feeling in a daze or as if time has slowed)
• Memory loss related to the event
• Avoiding memories, thoughts, or feelings associated with the event
• Avoidance behavior toward people, places, conversations, and situations associated with the event
• Disturbed sleep
• Irritability or angry outbursts
• Hypervigilance
• Difficulty concentrating or focusing
• An exaggerated response to stimuli (startle response)

Causes of Acute Stress Disorder

Acute stress disorder stems from exposure to an acute trauma event that threatens or causes serious harm to physical or emotional well-being. For example, causes of acute stress disorder can include surviving natural disasters, serious accidents, or physical or sexual assault. The intensity and impact of the traumatic event can vary, and not everyone who experiences a traumatic event will develop ASD.

Below are traumatic events that may cause acute stress disorder:

• Natural disasters (i.e., fires, floods, or earthquakes)
• Physical, emotional, or sexual abuse
• Motor vehicle accidents
• Plane crashes
• War
• Refugee camps
• Witnessing harm to others
• Witnessing death
• Experiencing sudden or severe illness

Risk Factors for Acute Stress Disorder

Several risk factors can increase the likelihood of developing ASD following a traumatic event. However, not everyone with these risk factors will have the disorder. People respond to trauma differently, and the development of ASD is a complex interplay between individual factors and the specific traumatic event experienced.

Factors that increase the risk of acute stress disorder include:

• Pre-existing mental health conditions: Individuals with pre-existing conditions such as anxiety disorders or depression may be more susceptible to developing ASD after a traumatic event.
• Avoidance coping: Engaging in avoidance coping, such as suppressing thoughts and emotions, can increase the risk of developing ASD.
• Poor support networks: Individuals with fewer resources and outlets to process their trauma are at a higher risk of ASD.
• Severity and intensity of the trauma: Experiencing a more severe and life-threatening traumatic event can increase the risk of developing ASD.
• History of previous trauma: Having a history of previous traumatic events can heighten the vulnerability to developing acute stress disorder after subsequent traumas.
• Personality traits: Certain personality traits like high levels of anxiety or being prone to stress can increase the risk of developing ASD.
• Gender: Women may have a higher risk of developing ASD compared to men, potentially due to biological and societal factors.
• Age: Younger individuals may be more susceptible to ASD, as they may have fewer coping mechanisms and struggle with processing and integrating their trauma experiences.

Complications of Acute Stress Disorder

Acute stress disorder can lead to various complications that significantly impact well-being and daily functioning. Constant anxiety can worsen sleep problems and contribute to maladaptive coping via substance use. In other cases, ASD can also affect relationships, as individuals struggle to regain emotional stability after experiencing trauma. Early intervention and appropriate treatment for ASD are crucial for reducing the risk of problems.

Below are the possible impacts of acute stress disorder:

• Post-traumatic stress disorder (PTSD): ASD can lead to PTSD if symptoms persist beyond one month or worsen over time.
• Depression: The distressing symptoms of ASD can contribute to the development or worsening of depression, a common mental health disorder characterized by feelings of sadness, hopelessness, and loss of interest in activities and life.
• Anxiety disorders: ASD can result in or exacerbate anxiety disorders such as generalized anxiety disorder, panic disorder, and social anxiety disorder.
• Substance use disorders: Individuals with untreated or unmanaged ASD may turn to substance use as a coping mechanism, sometimes leading to the development of substance use disorders.
• Occupational impairment: The symptoms of ASD can interfere with the ability to perform occupational responsibilities, potentially leading to job loss or difficulties at work.
• Relationship problems: ASD can impact the ability to form and maintain healthy relationships, resulting in interpersonal difficulties, social isolation, and strained relationships with friends and family.
• Sleep disorders: ASD can impact sleep quality, sometimes resulting in insomnia and nightmares.

How Is Acute Stress Disorder Diagnosed?

To be diagnosed with ASD, an individual must have experienced or witnessed a traumatic event and exhibit specific symptoms that cause significant distress or impairment in daily functioning. A licensed mental health professional can evaluate to determine if someone meets the criteria for ASD. They may also perform a differential diagnosis to rule out other possible causes of symptoms.