Acute Stress Disorder: DSM-5 Criteria

Updated October 5, 2022 by BetterHelp Editorial Team

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

Everyone experiences stress at one point or another. Although it would be great if we could go through life without stress, the sad reality is that stress is an ever-present aspect of the human experience. Whether we feel overwhelmed by conflicting obligations or we’re worried about an impending deadline at school or work, everyone experiences stress from time to time. But fortunately, for the most part, stress passes. Often, we say things like, “If I can just get through this week or get past this deadline, everything will calm down!” And, thankfully, that’s often true. Often, the thing we’re worried about blows over sooner or later, and— with a bit of time, rest, and self-care— we begin to feel calm again. If you are experiencing stress from PTSD, understanding the PTSD DSM 5 criteria could be beneficial. 

What Is Acute Stress Disorder?

Are You Struggling With Acute Stress Disorder?

UK health organisationMSD defines Acute Stress Disorder as “an intense, unpleasant, and dysfunctional reaction beginning shortly after an overwhelming traumatic event and lasting less than a month. If symptoms persist longer than a month, people are diagnosed as having posttraumatic stress disorder (PTSD).” As you can see from this definition, Acute Stress Disorder and PTSD share a few similarities in that both conditions are different from the simple and routine exposure to stress that most people experience on a daily basis.

To put this difference into a practical context, let’s consider two different scenarios. For example, imagine that your daily commute to and from work is routinely clogged with traffic. Every time you leave for work or head home, it seems as though your entire city has come out onto the highway! As a result, your commute may take 30 minutes longer than it should and you might feel irritable and frustrated. But even if you feel that frustration every day, you’re unlikely to develop Acute Stress Disorder as a result.

By contrast, someone who experiences a traumatic event such as sexual assault, domestic violence, a car accident, or the death of a family member is quite likely to develop Acute Stress Disorder as a result of their experience. Being affected by any of the traumatic events previously mentioned can also cause someone to develop PTSD. Thus, it’s easy to see how the stress of traumatic events mentioned in this example differ from the stress of a frustrating daily commute.

MSD concurs with this definition by explaining that “people with acute stress disorder have been exposed to a terrifying event. They may experience it directly or indirectly. For example, direct exposure may involve experiencing serious injury, violence, or the threat of death. Indirect exposure may involve witnessing events happening to others or learning of events that occurred to close family members or friends. People mentally re-experience the traumatic event, avoid things that remind them of it, and have increased anxiety.

People with this disorder may have dissociative symptoms. For example, they may feel emotionally numb or disconnected from themselves. They may feel that they are not real. The number of people with acute stress disorder is unknown. The likelihood of developing acute stress disorder is greater when traumatic events are severe or recurrent.”

Symptoms of Acute Stress Disorder are very similar to symptoms of PTSD and can include:

  • Vivid and disturbing memories of the traumatic event
  • Intense memories that feel as though the event is re-occurring in real time (often called “flashbacks”)
  • Recurrent nightmares about the event
  • Recurrent and unwanted intrusive thoughts about the event
  • Extreme emotional and physical reactions to stimuli that triggers a reminder of the event
  • Feeling as though you are constantly on “high alert”
  • A persistent feeling that you are unsafe
  • Self-destructive behavior
  • Difficulty sleeping
  • Difficulty concentrating
  • Difficulty maintaining relationships or holding down a job
  • Feeling numb, depressed, or hopeless
  • Trouble concentrating

All of these symptoms can be hallmarks of Acute Stress Disorder, so if you’re experiencing any or all of these symptoms, it’s important to mention them to your doctor and/or therapist.

How is Acute Stress Disorder Diagnosed?

We’ve already seen that Acute Stress Disorder and PTSD are very similar but it’s also very important to consider the differences that set them apart. Diagnostically speaking, the primary difference between Acute Stress Disorder and PTSD has to do with the duration of symptoms. Symptoms of Acute Stress Disorder commonly last anywhere from three days to four weeks while PTSD is diagnosed after symptoms have been present for more than a month. Treatment experts at rehab centre Recovery Village explain this difference by observing that “Acute Stress Disorder refers to the initial traumatic symptoms that arise immediately after a traumatic event. PTSD refers to the long-term aftermath of trauma.”

Treatment for Acute Stress Disorder

In practice, the treatment options that are available for Acute Stress Disorder are very similar to those used to treat PTSD. The treatment option that works best for you will vary depending on your specific case but common treatment options for Acute Stress Disorder and/or PTSD can include:

  • Trauma-informed Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (which is commonly referred to by the abbreviation CBT) is considered the gold standard in therapeutic treatment for anxiety disorders. And because most symptoms of Acute Stress Disorder and PTSD cause extreme anxiety, CBT can be very helpful for treating those symptoms and alleviating anxiety. So, how does CBT actually work in practice? The simplest definition is that CBT is a type of talk therapy. This form of therapy is designed to reduce anxiety by reframing our thoughts and providing a positive alternative to the stories we tell ourselves.

For example, if you are someone who experiences high levels of anxiety on a daily basis, you may often think, “I’m so nervous” or “Everyone is staring at me” or “Everything is going to go wrong!” These are common fears that people with anxiety experience and these fears inform our behavior and, consequently, our perceptions of situations. But CBT aims to alter this internal monologue by reframing your thoughts in a more positive and rational context so you can go through life without being paralysed by these fears.

For example, CBT often encourages people to avoid a practice known as “black and white thinking.” This type of thought process is common for people who live with anxiety because the anxious brain tends to think in extremes as a result of the fear signals that are flooding the brain. In practice, this might cause someone to think, “Everything is going to go wrong!” But CBT encourages people to reframe that thought by making a conscious effort to tell yourself something like, “I’m experiencing feelings of anxiety right now. My brain is causing me to worry that the worst possible outcome will occur.”

This might sound quite simplistic but, in reality, reframing your thought processes can be extremely beneficial! When we re-write our internal script, we can remember that thoughts and feelings are not facts; our brains may send us these signals but that doesn’t mean that these signals are accurate representations of reality. Re-training your brain in this manner can be incredibly beneficial for someone who is struggling with Acute Stress Disorder or PTSD and feeling constantly overwhelmed by fear signals in the brain. As a result of this cognitive re-structuring, it can be easier to overcome the signals your brain is sending you, and this can help people to feel happier, healthier, and more at peace.


Medication can also be effective for some people who are experiencing symptoms of Acute Stress Disorder. Many people who are living with Acute Stress Disorder struggle with severe feelings of depression and anxiety as a result of their symptoms, so anti-depressants and anti-anxiety medications can be very helpful in reducing the distress caused by these feelings. Each of these medications can be uniquely helpful in their own ways. For example, antidepressants can help to alleviate depression symptoms, while mood stabilizers can help people avoid the severe mood swings and angry outbursts associated with agitated depression. Likewise, medications that are specially formulated to reduce anxiety may help you feel a general sense of calm and holistically reduce your symptoms. However, it’s important to remember that you should only take medication that has been prescribed to you by a physician, whether that’s your primary care doctor or a licensed mental health professional.

Your doctor will also be able to prescribe additional treatments in addition to— or instead of— medication. For example, some people benefit from regular sessions with a therapist in addition to medication while others don’t respond to medication at all and find significant relief from their symptoms after solely treating their agitated depression with therapy. Connecting with a therapist can be highly beneficial because therapy provides you with professional insights about your symptoms and the arsenal of tools you need to fight depression and reclaim your peace of mind.

Connecting With a Therapist

Are You Struggling With Acute Stress Disorder?

If you’re experiencing symptoms of Acute Stress Disorder, it’s highly likely that you’re living with the effects of unresolved trauma. People who live with Acute Stress Disorder often feel conflicted or ashamed as a result of their symptoms, especially if they believe that they should be able to “shake it off” or feel that they should not be so adversely affected by the trauma they experienced. But it’s important to remember that these feelings are not realistic and they should not define your approach to trauma and treatment. People who live with Acute Stress Disorder often say in therapy that they feel their trauma “wasn’t that bad” or that “other people have it worse,” so it “shouldn’t be a big deal.”

But the truth is that none of that matters. No matter what type of trauma you experienced, your trauma is valid because it has a significant impact on you. And if you’re living with symptoms that are negatively affecting your quality of life, you deserve to find help and healing. And, most importantly, you deserve to know that you do not have to fight this on your own. Therapy can be extremely beneficial because it offers you a safe and supportive space in which to process your trauma.

Your therapist can work with you as you unpack your feelings and, together, understand why your experience impacted you in the way it did. From there, you can work together to develop a treatment plan and assemble an arsenal of positive tools and coping mechanisms that will help you address your symptoms. Whether this includes CBT, medication, or a combination of both, your therapeutic treatment plan can empower you to fight back, reclaim your peace of mind, and begin your healing journey.

So, if you feel ready to reach out and seek hope and healing through therapy, you may want to consider BetterHelp. With the advances in modern technology, many people have gravitated toward online therapy because this format is more convenient in our hectic, fast-paced world. Rather than needing to amend your schedule to attend an in-person therapy appointment, online therapy is literally right at your fingertips; you can chat with your therapist from the comfort of your own phone any time you want! So, don’t be afraid to reach out and ask for help. Hope is only a click away!

Below are commonly asked questions on this topic:

What is acute stress disorder in DSM-5?
What are the diagnostic criteria for acute stress disorder?
What is the difference between PTSD and acute stress disorder according to the DSM-5?
What are 5 symptoms of acute stress?
Is acute stress disorder a mental illness?
What is the best treatment for acute stress disorder?
What are examples of acute stress?
Does acute stress disorder turn into PTSD?
Is acute stress disorder an anxiety disorder?
What does acute stress do to the body?

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