Acute Stress Disorder
Acute Stress Disorder (ASD) is a trauma-related condition that develops within one month of exposure to a traumatic event. It's characterized by intrusion, negative mood, dissociation, avoidance, and arousal symptoms. If symptoms persist beyond one month, the diagnosis may change to PTSD.
Prevalence: Develops in 20-50% of trauma survivors within first month. Higher rates after interpersonal violence (assault, abuse) than accidents.
Common Symptoms
- Recurrent, involuntary, and intrusive distressing memories
- Recurrent distressing dreams about the trauma
- Dissociative reactions (flashbacks)
- Intense psychological distress at trauma reminders
- Marked physiological reactions to trauma cues
- Persistent inability to experience positive emotions
- Altered sense of reality (derealization)
- Inability to remember important aspects of trauma (dissociative amnesia)
- Feeling detached from oneself (depersonalization)
- Efforts to avoid distressing trauma-related memories or thoughts
- Efforts to avoid external reminders of the trauma
- Sleep disturbance
- Irritable or aggressive behavior
- Hypervigilance
- Problems with concentration
- Exaggerated startle response
- Feeling numb or emotionally unresponsive
- Confusion or disorientation
- Difficulty maintaining attention
Risk Factors
- Prior trauma exposure
- History of mental health disorders
- Lack of social support
- Severity of trauma
- Female gender
- Peritraumatic dissociation
- Negative cognitive appraisals
- Childhood adversity
- Family history of anxiety disorders
Treatment Approaches
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) - First line
- Cognitive Behavioral Therapy (CBT)
- Brief Eclectic Psychotherapy
- EMDR (Eye Movement Desensitization and Reprocessing)
- Cognitive Processing Therapy (CPT)
- Exposure therapy (with caution, may be early)
- Supportive counseling
- Crisis intervention
- Psychoeducation about trauma responses
- Relaxation training
- Medications: Short-term benzodiazepines (controversial, may impair processing)
- SSRIs if developing depression
- Sleep aids for severe insomnia
Self-Help & Natural Approaches
- Psychological First Aid (PFA) immediately after trauma
- Crisis counseling within 72 hours
- Grounding techniques (5-4-3-2-1)
- Deep breathing exercises
- Progressive muscle relaxation
- Regular sleep schedule
- Maintain daily routines
- Physical exercise (gentle walking)
- Social support from family/friends
- Journaling about emotions (not trauma details initially)
- Mindfulness and present-moment awareness
- Limit trauma exposure in media
- Nature exposure
- Avoid isolation
- Healthy nutrition and hydration
- Limit alcohol and caffeine
- Return to normal activities gradually
- Pet therapy
- Support groups for trauma survivors
- Body-based therapies (yoga, tai chi)
When to Seek Professional Help
- Symptoms develop within 1 month of trauma
- Symptoms interfere with daily functioning
- Experiencing intense distress
- Dissociative symptoms (feeling unreal)
- Suicidal thoughts
- Self-harm urges
- Substance use to cope
- Cannot return to work or school
- Avoiding important activities
- Symptoms not improving after 2 weeks
- Panic attacks
- Symptoms worsening over time
Crisis Resources
- 988 Suicide & Crisis Lifeline
- Crisis Text Line: Text HELLO to 741741
- SAMHSA National Helpline: 1-800-662-4357
- Disaster Distress Helpline: 1-800-985-5990
- RAINN (Sexual Assault): 1-800-656-4673
- Emergency: 911 or nearest ER
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.