What is acute stress disorder (ASD)?

Acute stress disorder (ASD) is a mental health condition that affects between up to one-third of people during the month following a traumatic event. It shares many symptoms with post-traumatic stress disorder (PTSD) with the key difference being that it doesn’t last as long. However, ASD can often turn into PTSD. 

Approximately 80% of people who develop ASD will eventually meet the diagnostic criteria for PTSD. So if you or someone you care about is navigating the aftermath of a distressing event, learning more about ASD can help you and your loved ones get the support you need to heal.

What do acute stress disorder symptoms feel like?

People cope with stress in different ways. Having a strong reaction to trauma doesn’t mean you have a mental health condition. But if you have an acute stress response after a traumatic event, it could be cause for concern. 

Some of the signs you might be living with ASD include:

• Experiencing increased anxiety
• Mentally reliving the event
• Avoiding anything that reminds you of the event
• Feeling agitated
• Having mood swings
• Feeling numb or disconnected from the world

The likelihood of developing ASD is greater when the trauma you experience is severe or ongoing. But to be diagnosed with the condition, you must exhibit a major decrease in functioning and at least nine of the following symptoms after a trauma exposure: 

• Upsetting, repeated, and uncontrolled thoughts and memories about the event
• Recurring dreams about the event
• Flashbacks, or feeling like you’re experiencing the event again
• Acute physical and/or mental distress when you encounter something that reminds you of the event 
• An inability to feel positive emotions
• Feeling detached from reality or as if you’re in a daze or time has slowed
• Difficulty remembering parts of the event
• Actively avoiding internal thoughts associated with the event
• Actively avoiding external reminders of the event
• Sleep disturbances
• Increased irritability or difficulty controlling anger
• Increased hypervigilance (always scanning your environment for possible signs of danger)
• Trouble focusing or concentrating
• Easily startled by loud noises, sudden movements, etc.

For people with ASD, these symptoms will start to go away after about a month. But if they continue, it could be a sign of PTSD or another trauma disorder.

How does acute stress disorder compare to PTSD?

ASD is a strong predictor of PTSD, but they’re not identical conditions. ASD represents a short-term, severe response to traumatic events that occurs within one month. PTSD — although it includes similar symptoms — is a long-term (sometimes lifelong) condition that typically requires ongoing care. Because of the persistent nature of the symptoms of PTSD, this condition often has a more severe effect on someone’s functioning, relationships, and worldview. 

Another important distinction is that PTSD causes symptoms like risky behavior, self-blame, decreased interest in activities, and social isolation, while ASD typically does not.

What causes acute stress disorder?

A group of people can experience the exact same traumatic event but respond to it differently. Some people may develop ASD and, later, PTSD, while others won’t. 

Certain forms of trauma may be more likely to cause ASD. These include rape, assault, physical injury, or other severe traumas. However, there are some additional factors that may increase your risk of developing ASD.

Pre-trauma risk factors include: 

• Being a person who was assigned female at birth
• Having a neurodevelopmental disorder that affects learning or cognitive ability
• Experiencing other traumatic events in the past
• Having a pre-existing personality disorder or other mental health condition
• Having a family history of ASD
• Lacking access to education

Post-trauma risk factors include: 

• Rapid heart rate (tachycardia)
• Experiencing socioeconomic challenges
• Experiencing intense physical pain 
• Having an ICU stay
• Having a brain injury
• Developing dissociative symptoms (i.e. disconnection from self or not knowing who or where you are)
• Having a disability
• Having other major life stressors

Are there known effects of living with acute stress disorder?

In addition to significantly increasing your risk of developing PTSD, there can be other damaging effects of living with ASD. Left untreated, ASD can:

• Increase your risk for substance use disorder (SUD)
• Lead to occupational and financial challenges (i.e. if you had a car accident, you might avoid driving, causing you to lose your job if you need to drive to get to work)
• Create problems in your relationships (i.e. if you’re increasingly irritated or having trouble controlling your temper, this could lead to conflict)
• Increase your risk of suicide*

*A note on safety: ASD carries an increased risk of suicidality. If you’re having thoughts of harming yourself, don’t hesitate to ask for help. You can contact the National Suicide and Crisis Lifeline by dialing 988 from any phone. Their counselors will provide confidential support and resources to help keep you safe.

How is acute stress disorder treated?

Your treatment experience will be based on your individual needs. However, these approaches are frequently used to help people living with ASD:

• Trauma-focused cognitive behavioral therapy (TF-CBT): This form of therapy involves learning how your mind and body respond to trauma, increasing coping skills, shifting unhelpful thought patterns, and reducing the impact of triggers.
• Self-care: Taking good care of yourself is critical after a traumatic event. Focusing on activities that increase your sense of personal safety and maintaining your physical health can help support your recovery.
• Medication: There are no approved medications for treating ASD. But sometimes, medication can be helpful in alleviating associated symptoms, like difficulty sleeping. You can ask your provider if this is the right option for you.

Find care with Rula

There’s no “correct” way to respond to trauma. People can react to distressing experiences in many different ways. However, for some, severe trauma can lead to the onset of ASD and, possibly, PTSD. Like other trauma disorders, ASD can negatively affect your mental and physical well-being, relationships, and daily functioning. 

When you need convenient, affordable, trauma-informed care you can access from the comfort of home, we invite you to explore Rula. With our therapist-matching program, you can quickly find an in-network provider, schedule your first session for as soon as tomorrow, and begin receiving the quality care you deserve. 

Find a therapist with Rula