Traumatic events can have significant impacts on our mental and physical health, both in the short and long term. Before it evolves into fully-fledged post-traumatic stress disorder (PTSD), some people will experience acute stress in the month following a traumatic event.
This condition can be extremely disruptive to normal life, causing someone’s sense of threat and alertness to go into overdrive. It might impact their sleep, cause recurrent flashbacks, and increase physical symptoms of panic.
This article will explain acute stress disorder (ASD) symptoms and treatment, which may involve a mixture of crisis stabilization, therapy, and medication. We’ll also explore the reasons why someone may require residential treatment for acute stress disorder and explain what these programs typically involve. These settings can provide comprehensive treatment for people with the most serious symptoms, enabling recovery and long-lasting coping strategies.
With that in mind, let’s dive in!
Acute stress disorder (ASD) is a stress response that occurs between three days and four weeks after a stressful event.1 Outside of medical circles, it may be referred to as “shock.” It’s a psychological response to something surprising, terrifying, or traumatic. It’s not fatal, but it can feel extremely intense and overwhelming.3
There are two types of stress response: Sympathetic and parasympathetic.
Sympathetic stress is also known as the “fight or flight” response; it involves the excessive release of adrenaline and norepinephrine. These hormones cause physical reactions like an elevated pulse, dilated pupils, increased breathing, and the suppression of pain.3
Parasympathetic stress is when the body releases acetylcholine, causing someone’s heart rate to slow and for them to potentially lose consciousness. Instead of prompting us to fight or flee our attackers, this could be compared to the “play dead” or “freeze” strategy.3
While these stress responses have their uses during dangerous and threatening events, they persist in people with ASD and PTSD when there’s no longer a real threat present. This can have a big negative impact on their life.
ASD is a fairly new diagnosis that is distinct from PTSD and other acute stress reactions (ASRs). While ASD is a type of acute stress reaction, when it continues beyond the four-week period following a stressful event, it then meets the criteria for PTSD. Of those who develop ASD, between 1 and 11% will develop a long-term condition like PTSD.1
Causes of Acute Stress Disorder
Research finds that between 20 and 90% of people will be exposed to one or more extremely stressful events in their lives.1 Traumatic events are those that impact someone’s physical, mental, emotional, or spiritual well-being long-term. Examples of traumatic events include:2
Physical or sexual assault
There are many more examples of events that could be traumatic, and what may be traumatic for one person may not be for another. It is not fully understood why some people recover quickly from traumatic events and others don’t, but it’s not a personal failure.1
Our brains are wired to respond strongly to threats, whether it’s through “fight or flight” or freezing. It’s totally normal for people to be more vigilant for new threats after a traumatic experience. For people who experience interpersonal trauma, between 20 and 50% of them will develop ASD.4
Symptoms of Acute Stress Disorder
In order to receive a diagnosis of ASD, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) gives a set of criteria. Beyond having been exposed to a traumatic event, people must experience more than 8 of the following symptoms:1
Recurring distressing memories of the event
People with ASD may also feel a great deal of guilt after the event, perhaps around not being able to prevent it or having survived it while others didn’t.4 Acute stress disorder recovery support will not only help to manage these symptoms but also address the root cause, which we’ll explore now.
When someone first seeks support for stress following a traumatic event, healthcare providers will focus on a few things before treatment can begin. The first priority is safety: if someone is suicidal or in crisis, they’ll need to be treated differently from those who aren’t at any immediate risk.5
People will next be assessed for what they need in terms of medical care, rest, nutrition, and any injury-related pain. This will determine the kind of care that’s needed before mental health treatment.5
Next, clinicians will want to gather information about the traumatic event and any historic traumas someone may have experienced. They’ll conduct a psychiatric evaluation to understand things like:5
Comprehensive assessments like these give clinicians a clear picture of what factors are converging to impact someone, their symptoms, and potentially their recovery. It will help them determine the right treatment setting, whether it’s an outpatient service, acute stress disorder inpatient care, or partial hospitalization.5
Evidence finds that cognitive-behavioral therapy (CBT) has the most success treating people with ASD, though other therapies are effective, too. CBT for ASD will firstly aim to change the way someone thinks about the traumatic event, then it’ll try to alter their behaviors in anxiety-inducing situations.4
Group therapy may also be helpful for some people. While it may re-traumatize some to ‘relive’ their traumatic memories, some find it very beneficial to talk through their experience with other people.4
Another trauma and acute stress treatment is EMDR, which stands for eye movement desensitization and reprocessing. This approach involves guiding someone through certain eye movements while recalling traumatic memories, helping to reduce their emotional impact.5
You may be referred to psychodynamic therapy, which focuses on the meaning of the trauma for someone in the context of their prior life experience. For instance, how it relates to their historical feelings around relationships and self-esteem. Psychodynamic therapy is less action-based than CBT, so it may take longer, but it’s still a valuable option for many people.5
Many therapies for anxiety and stress-related conditions will involve something called exposure therapy. This is a method with roots in CBT that involves a controlled exposure to something that causes someone to feel fear or panic. Through gradual exposure, people experience a reduction in stress towards that trigger and are therefore less controlled by their desire to avoid it. This can be transformational for returning to everyday life.1
At the moment, there’s no evidence indicating a particular medication’s superiority for treating acute stress disorder. However, due to its similarities with PTSD, medications typically prescribed for people with PTSD may be the most effective option we currently have. These include:1
While these medications can help support someone during treatment, they won’t address their root cause. Often, therapy is necessary to unpack someone’s experiences, help them develop coping strategies, and unburden them from the weight of the trauma.
While therapy and medication can be a helpful combination for many people with acute stress disorder, some may be best treated within inpatient settings. These are residential facilities that provide 24/7 care, involving a range of therapeutic approaches.
You can expect daily therapy (in both individual and group settings), medication management, structured meal times and activities, and classes that focus on coping skills and psychoeducation.
It may be that someone’s ASD is impacting them so severely that they cannot perform normal daily tasks. If someone cannot look after themselves or is a risk to themselves or others, an inpatient program can help them recuperate from that point of crisis.
Psychiatric treatment is often most effective when it has been personalized to each individual, which is something inpatient settings can do to a great extent. They can customize each element of a person’s daily routine, providing a treatment that targets their unique symptoms and life history.
Acute stress disorder therapy programs may offer stays varying from 3 days to two years. These allow people to stay for as long as they need to process their trauma, adjust to medications, and cultivate useful skills.
Trauma-focused inpatient programs will have a special focus on how traumatic experiences can impact mental health. These settings will be ideal for people with ASD or PTSD, as everything will be geared toward recovering from these conditions. However, some inpatient settings will be trauma-informed, even if they don’t advertise this as their main focus.
At AMFM, we believe your story is more important than your diagnosis. That’s why our treatments go beyond traditional approaches; while therapy and medication are important, we also support people with positive, nurturing relationships, long-term coping skills, and even nutritious meals.
If you’re looking for acute stress disorder help, we offer various approaches, including outpatient, inpatient, and partial hospitalization services. We have multiple facilities across California, Minnesota, and Virginia for inpatient trauma recovery. When verifying your insurance, you can expect us to contact you within an hour to discuss your treatment options.
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