Everything to Know About Acute Stress Disorder, According to Mental Health Experts

Including who's at risk and what the symptoms are.

Most people, unfortunately, will go through a high-stress event in their lives—a medical emergency, the effects of a natural disaster, a traffic accident. And regardless of the specific traumatic event, everyone will respond to that trauma differently.

One way that someone can respond to trauma is through developing what's known as acute stress disorder, or a particularly strong reaction to trauma soon after the event occurs, Shannon O'Neill, PhD, an assistant professor of psychiatry at Mount Sinai Hospital in New York, tells Health. "From a therapeutic perspective, acute stress disorder is focused on the short-term reaction to a trauma that was experienced," Dr. O'Neill explains. And you don't have to be at the center of a traumatic event for it to impact you; it can happen if you witness another person experience a trauma, or even learn of one endured by a relative or close friend.

While acute stress disorder is a diagnosis similar to post-traumatic stress disorder, the time frame during which each happens is an important distinguishing factor. If a person experiences a strong emotional reaction to a traumatic event in the month following the event, they're likely suffering from acute stress disorder. If they begin or continue experiencing a reaction after the one-month anniversary of the trauma, they're suffering from post-traumatic stress disorder (PTSD), Susan Albers, PsyD, a psychiatrist at Cleveland Clinic, tells Health. It's also important to note that not everyone who experiences acute stress disorder will go on to suffer from PTSD, and, likewise, some people who suffer from PTSD didn't experience acute stress disorder right after the trauma, Dr. O'Neill says.

Anyone who has experienced a trauma is thought to be at risk of suffering from acute stress disorder, but certain people within that group may be at higher risk, including those who, by nature, tend to be avoidant (meaning they might not be as likely to address their trauma head-on after experiencing it), Dr. O'Neill says.

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What Are the Symptoms of Acute Stress Disorder?

While everyone can experience a trauma response—and acute stress disorder, specifically—in different ways, there are five categories of acute stress disorder symptoms, Dr. O'Neill says. Those include:

  • Dissociation. Symptoms in this category include experiencing an altered perception of time and a detachment from your own body following a traumatic incident.
  • Intrusion. These symptoms include flashbacks to the traumatic incident, nightmares about it, or any other intrusive feelings that enter the mind.
  • Arousal. Symptoms include having difficulty focusing, hypervigilance, feeling irritable, and feeling charged up.
  • Avoidance. This includes avoiding stimuli that remind you of the trauma you experience, such as certain places, feelings, or even people. (Remember, people who naturally behave this way might be more susceptible to acute stress disorder.)
  • Negative mood. This could mean having a hard time experiencing positive emotions and feeling down all the time.

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How Is Acute Stress Disorder Diagnosed and Treated?

A mental health professional can diagnose acute stress disorder when a patient who has recently experienced a trauma says they're experiencing any of the above symptoms. And treatment may or may not be necessary. "The good news is that many people get better without needing treatment," Dr. O'Neill says.

If a patient does need treatment, they'll likely be directed to talk therapy. "The first thing you would do is engage in cognitive behavioral therapy," Dr. Albers says. If the patient is avoiding the incident, it might be helpful to talk about it, she adds. "Talking about the story and connecting with other people, telling your story instead of avoiding [and] pretending it didn't happen, shutting down, isolating—it helps."

While a timely diagnosis is important, you shouldn't necessarily reach out to a mental health expert in the hours after a traumatic incident if you don't feel you need to at that particular time. Dr. O'Neill says that, in the past, the thinking was that debriefing right after a trauma was healthy, which is why in the aftermath of natural disasters, mental health experts were always on-site and ready to engage with victims. But "research has shown that the talk-it-out method immediately following trauma has various effects on people," she says, explaining that these effects aren't always exclusively positive. Still, it's important to monitor your feelings in the days and weeks after experiencing a trauma, especially after that three-day mark, after which acute stress disorder can set in.

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