Acute Stress Disorder – Causes, Diagnosis, And Treatment

Content/Trigger Warning: Please be advised, the below article might mention trauma-related topics that include sexual assault & violence which could potentially be triggering.

Stress can be a natural byproduct of changes that cause physical, psychological, mental, or emotional tension. Often, after you go through a particularly stressful situation or event, it takes time to refocus and get yourself back on track. Self-care, support, and time are typically enough to recover and move forward from these events. However, in people with Acute Stress Disorder (ASD), things aren't that simple. In this article, we’ll focus on acute stress disorder including its causes and diagnosis, and some of the treatments available.

What Is Acute Stress Disorder?

Acute stress disorder (ASD) was introduced in 1994 into the Diagnostic and Statistical Manual for Mental Health (DSM-IV.) The general current diagnostic standard for a psychiatric diagnosis of ASD resembles that of post-traumatic stress disorder (PTSD). The main difference between the two is that a diagnosis of ASD can only be provided within four weeks after a traumatic event. Also, the criteria for a diagnosis of ASD have a larger emphasis on dissociative symptoms as compared to PTSD.

Causes Of Acute Stress Disorder

Although more research needs to be undertaken into factors that may put certain individuals at an increased risk of developing ASD, there is some information to assert that the condition occurs after a particularly stressful and upsetting event. When the term 'acute' is used, it refers to symptoms that come on rapidly but that do not last for a great length of time.

You may find yourself developing ASD if you have an unexpected life crisis, such as:

• A terrorist event

• War

• A major disaster

• A serious injury or accident

• Assault

• Rape

• Domestic violence

• Sudden bereavement 

• And more

Diagnosis Of Acute Stress Disorder

To be diagnosed with acute stress disorder, your symptoms must persist for a minimum of 3 days and up to 4 weeks. These symptoms must also first show within four weeks of the stressful event. Your doctor or therapist may also need to rule out other potential causes of your symptoms, including:

• Health problems

• Drug or alcohol misuse

• Medication side effects

• Other psychiatric disorders

A crucial feature in the diagnosis of ASD is dissociation, where you feel your mind is detached from your body or your emotions. This may also be characterized by you viewing the world as being unreal or as though you are living in a dream. Dissociative amnesia where you have a poor memory of traumatic events is another sign that you may have ASD.

Acute Stress Disorder Vs. PTSD

It's true that the defining symptoms of ASD often overlap with those of post-traumatic stress disorder. However, the real difference between the two conditions is time. If your symptoms of ASD last for longer than one month and if they cause you great distress or an inability to function as normal after a traumatic event, your diagnosis may then be changed to chronic PTSD—provided you meet the criteria for this disorder. 

Current Treatments For Acute Stress Disorder

Sometimes, no treatment at all is needed for ASD as the symptoms tend to go away after you have dealt with the traumatic situation. You may find that all you need to understand and get past your symptoms is to comprehend the underlying cause and to talk things over with loved ones.

However, those struggling with symptoms of acute stress disorder a month or more after a significant traumatic event may need extra support and treatment to move forward. 

A key element of treating ASD can be regaining your sense of empowerment. 

• Define and achieve treatment goals

• Break down your problems into manageable pieces

• Develop and utilize coping skills

• Teach you techniques to reduce arousal

• Manage your emotions and thoughts

• Create a restful sleep routine

As well as counseling, other helpful treatments for ASD can include:

Cognitive Behavioral Therapy (CBT)

Trauma-focused CBT is a form of talk therapy that's built around the concept that thinking a certain way can fuel some mental health issues due to a traumatic event. CBT can guide you to understand your thought patterns and to identify any that are unhelpful. You can then work to change the way you think, which may help you experience more positive emotions. Your thought patterns might become more helpful and less worrisome over time. 

In Cognitive Behavioral Therapy, issues are broken down into five areas:

• Actions

• Situations

• Physical feelings

• Emotions

• Thoughts

CBT has its roots in the concept that each of these areas is interconnected and affects the other. CBT can enable you to identify and pinpoint specific issues and solve them using psychological debriefing. 

Medications

Taking medicine to help you through ASD can sometimes be an option. You may be prescribed beta-blockers. Beta-blockers can relieve some symptoms that arise when your body releases stress hormones. These drugs do not cause drowsiness and do not act like tranquilizers so you can function normally without worry. Other types of medications may be prescribed as well, but it’s important to always consult a doctor before deciding to start or stop a new medication.

Who is Most at Risk for Acute Stress Disorder?

Although anyone can develop the condition after enduring a trauma, certain groups run a higher risk of having ASD according to the American Psychiatric Association. 

These include:

• People with a history of developing PTSD, ASD, or other mental disorders

• People with a history of experiencing dissociative symptoms at times of trauma

• Individuals who have been through a traumatic event in their past

• Individuals with mental health problems

Effects and Symptoms of Acute Stress Disorder

When you have been exposed to a very stressful or traumatic event and go on to develop ASD, your symptoms will often develop within hours or even minutes. For some people, these symptoms will pass as quickly as they arrived. For others, they last for days or several weeks. If you're worried that you or someone close to you may develop ASD, look out for some of the following symptoms:

Physical Symptoms

Physical symptoms are caused by stress hormones being released into your bloodstream as well as over-activity of nervous signals to different parts of your body. According to the American Psychiatric Association, symptoms you may display include:

• Nausea

• Palpitations

• Headaches

• Chest pains

• Breathing problems

• Abdominal pains

Psychological Symptoms

You may also experience some of the following:

• Cutting yourself off from friends and family

• No longer enjoying once enjoyable activities

• Anxiety

• Anger

• Sadness

• Tearfulness

• Low mood

• Poor concentration

• Irritability

• Feeling on guard or tense

• Being unable to sit still

• Being easily startled

• Recurrent intrusive and unpleasant flashbacks or dreams

• Self-destructive or reckless behavior

Dissociative Symptoms

Dissociative symptoms can include:

• Feelings of emotional detachment

• Avoidance of people, places, and anything else that may trigger memories of the traumatic event

• Feeling that your emotions or thoughts don't belong to you or don't seem real

• Reduced awareness of life around you

• Altered sense of reality

• Feeling your environment seems unreal or strange

• Difficulty concentrating

• Being unable to remember some of the crucial aspects of the traumatic event (dissociative amnesia)

What if Symptoms Persist?

As discussed earlier, if your symptoms of ASD last for more than a month after a traumatic event, it can be important for you to speak to a doctor to be assessed for post-traumatic stress disorder. Acute stress disorder is a condition that can often be overcome with the help of a counselor or other medical professional. If you've been through an event that has had a significant effect on you, it might be time to seek the help you need.

Online Therapy With BetterHelp

Experiencing stress can have negative physical and mental health benefits that may worsen if left unaddressed. Working with a therapist can help you understand the severity and impact of your stress. BetterHelp is an online counseling platform that has thousands of licensed therapists who have experience in a variety of areas—including stress. You can get matched with one from the comfort of your home and meet with them according to your schedule. Online counseling removes many of the stressful barriers to traditional therapy, such as affordability, transportation problems, time constraints, and more.

The Effectiveness Of Online Therapy

Researchers have found that internet-based cognitive behavioral therapy helps “provide patients a better understanding of their illness.” ICBT programs have been shown to be efficient in managing participants’ overall stress by reducing its severity and decreasing urges and stress levels. Online-based therapy has also been shown to increase life satisfaction and cognition.

The Takeaway

Acute stress disorder can be difficult to manage by yourself. Following a traumatic event, it can be important to find support so that you can cope and move forward in a healthy manner. Since the symptoms of ASD are often similar to PTSD, working with a professional can help you determine which disorder you’re struggling with. They can also recommend helpful treatment options and ways to manage your symptoms. Sometimes, certain stressful events can make it difficult to leave the house or be in certain environments. Working with an online therapist can allow you to receive mental health care from the familiarity of your home.