A Guide to Acute Stress Disorder

Acute stress disorder, commonly known as A.S.D., is a mental health condition one may develop after experiencing a traumatic event. Symptoms of A.S.D. typically last for a couple of months. However, if the symptoms persist beyond this time, the person may have post-traumatic stress disorder or P.T.S.D.

What is A.S.D.?

A.S.D. is a psychological condition that may occur due to a traumatic event. This event may have happened directly to you, such as in a car accident or to a close family member or friend. In a study, 14-33 per cent of the participants who went through severe trauma developed A.S.D.

The symptoms of A.S.D. typically last for a month or less. It is a precursor to P.T.S.D. because symptoms lasting more than a month denote that the person has P.T.S.D. Almost half the people who have A.S.D. also develop P.T.S.D.

Symptoms of A.S.D.

The symptoms of A.S.D. can be broadly classified into five categories:

Intrusion symptoms: These include dreams, memories, or flashbacks. They occur when a person repeatedly revisits a traumatic event in their mind. Symptoms include:

• Reliving a traumatic event.
• I have recurring images, illusions, nightmares, thoughts, or flashbacks of a traumatic situation.
• I am feeling distressed about the memory of the traumatic event.

Dissociative symptoms include symptoms where a person lives in an altered sense of reality. They may black out parts or all of the traumatic events from their memory or lack awareness of their surroundings. Symptoms include:

• Reduced sense of understanding of the surroundings.
• Feeling detached, numb, or emotionally unresponsive.
• Depersonalization – your emotions or thoughts don’t seem real.
• Derealisation – your environment feels unreal or strange.
• Dissociative amnesia – you can’t remember aspects of a traumatic event.

Avoidance symptoms: People with these symptoms avoid feelings, thoughts, places, or people associated with a traumatic event. Symptoms include:

• Avoiding people
• Avoiding places
• Avoiding conversations
• Avoiding certain activities
• Avoiding feelings and thoughts

Arousal symptoms include insomnia, difficulty concentrating, sleep disturbances, physical and verbal aggression, and irritability. They may also feel tense and get startled easily. Symptoms include:

• Having trouble sleeping
• Having difficulty concentrating
• Being irritable
• Being constantly tensed or on guard
• Inability to sit still or stop moving
• Being startled easily or at inappropriate moments

Negative mood: A person with A.S.D. may feel low or think negative thoughts. The symptoms may disrupt essential aspects of your life, such as your work or family. You may fail to start or complete essential tasks. You may also be unable to tell others about the traumatic event you went through.

People with acute stress disorder may also develop other mental health issues, including depression and anxiety.

Causes of A.S.D.

The trigger of A.S.D. could be an exposure to serious injury, death, or sexual violation in any of these ways:

• Direct experience of a traumatic event(s)
• Being witness to a traumatic event as it occurs to someone else
• Learning about a traumatic event happening to someone close to you
• Repeated exposure to the aversive details of a trauma, such as repeatedly talking to the police, first responders, etc.

How is A.S.D. diagnosed?

A mental health professional or doctor can diagnose acute stress disorder. The healthcare professional will diagnose you with A.S.D. only if you have experienced a minimum of nine or more signs within one month of the traumatic event.

To diagnose A.S.D., your doctor must rule out other possible causes of the symptoms, including underlying medical conditions, substance abuse, and other psychiatric disorders.

Treatment of A.S.D.

Your healthcare provider will work with you to develop a treatment plan that suits your particular requirements. The treatment of A.S.D. focuses on treating the symptoms, preventing P.T.S.D. from developing, and improving your coping mechanisms. The most effective treatment options include:

• Cognitive behavioural therapy: Many doctors recommend cognitive behavioural therapy as the first line of treatment for A.S.D. You work with a mental health professional to develop effective coping strategies here. Cognitive behavioural therapy helps when the person is not exposed to the traumatic event anymore and has regained some stability in life. The treatment involves teaching the patient to deal with the trauma’s effects and sharing ways to avoid triggers.
• Other types of psychotherapy used for treating A.S.D. include prolonged exposure (P.E.) and cognitive processing therapy (C.P.T.).
• Mindfulness: Mindfulness-based interventions use techniques that help to manage anxiety and stress. Some examples of mindfulness exercises are breathing techniques and meditation.
• Medications: If required, your healthcare professional may prescribe medications such as anti-convulsants or anti-depressants to treat the symptoms of A.S.D. While not the first line of treatment for A.S.D., medications are often combined with psychotherapy for the effective treatment of A.S.D. The most commonly prescribed medications include:

1. Benzodiazepines
2. Propranolol
3. Hydrocortisone
4. Selective serotonin reuptake inhibitors

Conclusion

Acute stress disorder is closely related to post-traumatic stress disorder and shares many symptoms with the latter. However, A.S.D. is a more short-term disorder and typically subsides within a month. On the other hand, P.T.S.D. is a chronic condition, and its symptoms last much longer than a month.

Treatment for A.S.D. aims to provide relief from symptoms and develop effective coping strategies in the individual. Reaching out to family and friends or joining community support groups can also help you process your feelings and move on from a traumatic event.

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