Acute stress disorder (ASD) can happen within a month of experiencing a traumatic event, like a natural disaster or assault. It’s closely related to post-traumatic stress disorder (PTSD). The main treatment for acute stress disorder is psychotherapy (talk therapy).
Acute stress disorder (ASD) is a short-term mental health condition that can occur within the first month after experiencing a traumatic event. It involves stress responses, including:
Examples of traumatic events include:
Acute stress disorder can affect a person at any stage of life — childhood, adolescence and adulthood.
The main difference between acute stress disorder and post-traumatic stress disorder (PTSD) is the length of the symptoms.
Acute stress disorder involves stress reactions that happen between three days and four weeks following a traumatic event. Stress reactions lasting longer than four weeks may meet the criteria for PTSD.
The American Psychiatric Association first classified acute stress disorder as a mental health diagnosis in 1994 in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).
Adjustment disorder is a mental health condition that happens in response to a stressful life event. The emotional and behavioral symptoms are generally considered more intense than what would be expected for the type of event that occurred.
The difference between acute stress disorder and adjustment disorder is that the stressful event in adjustment disorder (such as losing your job or the ending of a relationship) is typically less traumatic than an event that causes acute stress disorder (such as sexual assault or surviving a mass shooting).
It’s difficult for researchers to assess how common acute stress disorder is. This is partly because people may not seek professional help until their symptoms meet the criteria for PTSD.
According to various studies, the prevalence of acute stress disorder following a traumatic event may range from 6% to 33%. The rates also differ for different types of trauma. For example, survivors of accidents or natural disasters show lower rates of ASD. Survivors of violence, such as assaults and mass shootings, show higher rates of ASD.
Symptoms of ASD are psychological and behavioral stress responses. They may include:
It’s unclear why people respond differently to traumatic events.
One theory involves the concept of “fear conditioning.” This happens when your body exhibits a fear response to certain stimuli associated with a traumatic event. For example, if you were in a car accident and you had fast food in your vehicle and it was nighttime, future encounters with the smell of fast food at night may trigger your body to have the same fear response that you did during the traumatic event even though there’s no threat to your safety.
Some people may adapt to fear conditioning via extinction learning, which involves a gradual reduction in response to the traumatic triggers. If this doesn’t work, you could develop acute stress disorder and potentially PTSD.
Acute stress disorder risk factors may include:
The main complication of acute stress disorder is the potential development of post-traumatic stress disorder (PTSD). PTSD may develop if acute stress disorder isn’t treated.
There’s no test to diagnose acute stress disorder. Instead, a healthcare provider makes the diagnosis after conducting a thorough psychosocial assessment. They’ll ask about your current symptoms and about your medical and mental health history.
Providers use criteria explained in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) to diagnose acute stress disorder.
This therapy takes place with a trained, licensed mental health professional, such as a psychologist or psychiatrist. It provides support, education and guidance to you and, if necessary, your family/support system.
Trauma-focused CBT involves:
Exposure therapy involves safely exposing you to your sources of fear and avoidance. People with acute stress disorder may avoid things or situations that they associate with the traumatic event. Because of this, they aren’t able to learn that they can manage their fears when presented with these stimuli. Therapists use exposure therapy for people who have ASD to slowly encourage them to enter situations that cause them anxiety and to try to stay in that situation so that they can learn to cope.
While there’s minimal evidence supporting the use of medications to treat acute stress disorder, some medications may alleviate the symptoms of PTSD, including:
You can’t necessarily prevent a traumatic event. But research shows that the intensity of acute stress disorder symptoms is manageable. The following can help:
The prognosis (outlook) for acute stress disorder varies. If symptoms are untreated, the potential for further difficulties increase, including:
If you or a loved one are experiencing suicidal thoughts, dial 988 on your phone to reach the Suicide and Crisis Lifeline.
In addition to seeking professional treatment for acute stress disorder, you may benefit from positive activities, including:
It’s also important to see your medical healthcare provider and/or mental health provider regularly following a traumatic event.
If you’re experiencing thoughts of suicide or self-harm, it’s crucial to contact 911, go to the nearest emergency department or call 988 to reach the Suicide and Crisis Lifeline.
A note from Cleveland Clinic
It may be very difficult to seek professional help following a traumatic event. Know that treatment for acute stress disorder (ASD) is important, and with time, treatment can help you feel better. Talk to your healthcare provider about treatment options, and remember that they’re available to help and support you.
Last reviewed by a Cleveland Clinic medical professional on 02/21/2023.
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