Acute Stress Reaction

Adjustment disorder

They both can happen soon after a bad situation. However, adjustment disorder can occur after a bad event and not necessarily a traumatic one. That is to say, to qualify for a diagnosis of Adjustment Disorder the event has to be traumatic.

On the other hand, timeframes in particular are also relevant. That is to say, Acute Stress Reaction as a diagnosis is often made within a month of the trauma. After a month, PTSD is often diagnosed with those circumstances. With adjustment disorder, you are looking for symptoms to appear within 3 months and end by about the 6-month mark.

Depression

It is expected that depressive symptoms can happen following a traumatic event. A diagnosis of depression is warranted if there are depressive symptoms. Such as persistent low mood, lack of interest, hopelessness, guilt and other depressive symptoms. In addition, depression involves repetitive thinking patterns. Whilst an Acute Stress Reaction has more anxiety symptoms.

Panic Attack

Panic attacks are quite common following a traumatic event. However, in Panic disorder, there is anticipatory anxiety, dread of having another panic attack

1. Dissociative episodes

It is not that uncommon for people following traumatic events to present with dissociative symptoms, disturbance or amnesia. If the dissociative symptoms are the main, primary intervention these people should be diagnosed with either depersonalisation or derealisation disorder. However, if there is more to the presentation, then a diagnosis of Acute Stress Reaction might be better fitting.

2. Drug misuse

After repeated periods of substance intoxication, certainly, withdrawal symptoms may develop. These can appear similar to anxiety states, hyperarousal, distractibility and aggressive behaviour can play a part.

Acute Stress Reaction as a conceptual diagnosis is relatively new. We’ve listed below our thoughts on drivers or factors involved or contributing to the development of this stress reaction.

• Previous psychiatric illnesses or psychological traumas – Trauma is additive. For instance, having past traumatic experiences, PTSD or adjustment disorders can make people more susceptible to further stressors. There may also be unresolved issues from previous trauma.
• Use of avoidant coping mechanisms – this could be both behavioural avoidance and or psychological avoidance. Often times moving away or avoiding situations can be protective; however, the trauma can linger. It can then express itself by means of an acute stress response.
• More severe trauma – Understandably a more traumatic experience will have a greater impact,
• Neuroticism – An overthinking mindset, worry and self-doubt can leave someone feeling powerless or out of control following a traumatic event. This mindset would leave you prone to developing an acute stress reaction.

There is little in the way of population-based research on Acute Stress Reaction. This is understandable; it is a new diagnostic construct and a short term condition. However, it is one commonly encountered by mental health clinicians.

Traumatic events commonly linked with Acute Stress Reactions are motor vehicle accidents, head injuries, personal injuries, work accidents, and terrorist activities.

Acute Stress Reaction is listed in the World Health Organisation (WHO) diagnostic manual, ICD-10. The key features of the diagnostic criteria are as follows:

• The condition can be diagnosed immediately following a traumatic event
• If the psychological symptoms of the trauma last for longer than 1 month a diagnosis of PTSD may be more appropriate.
• The condition is characterised by dissociative symptoms; vivid recollections, avoidance of triggers and hyperarousal.

Whilst these form the key diagnostic features, it is important to remember that trauma presents differently in different people. For some avoidance; may mean spending more time in bed, being closed from others and feeling numb.

In order to diagnose an Acute Stress Reaction psychologists and psychiatrists will often ask many questions, as part of a holistic interview. They will want to know a bit about the traumatic events, supports you have, whether you feel safe, your past mental health and other aspects.

Oftentimes no professional treatments are indicating. An Acute Stress Reaction as per its definition is a time-limited condition. However, there are different types of help that can be explored:

Family, community and other non-professional supports

Oftentimes due to long waitlists people struggle to access professional supports soon after a traumatic event. Talking things over with a friend can help. Discussing what has happened with a family member or other trusted supports is advised.

Police intervention and legal supports

It is important to feel safe following a traumatic event. Sometimes going to the police to have an intervention order can help feel safe. Getting legal advice can give us a better understanding and a sense of control.

Psychology

Supportive interventions and cognitive behavioural therapy can help. These treatments work by learning about trauma responses, ways to reduce anxiety and challenge unhelpful thoughts.

Exposure therapy quite heavily uses in PTSD; therapists are using aspects of it when managing acute stress reactions. Exposure challenges can do by imagination but also by person. Exposure work often starts in session with a therapist before doing it by oneself.

Online supports

There are increasing numbers of online therapy modules for trauma, support groups, and educational resources.

There are few high-quality studies looking at medication and treatment of Acute Stress Reaction. The majority of people with an Acute Stress Reaction do not prefer medication to work through their struggles.

Benzodiazepines are classified as sedating medication. The World Health Organisation publishes articles stating that benzodiazepines, such as diazepam, should not use in the first month following a traumatic event.

The general view when prescribing calming or sleeping medication is the lowest possible dose, for the shortest period of time. Sleep often is key to recovery, sometimes behavioural strategies to help with sleep aren’t enough. Some GPs and Psychiatrists do use low dose benzodiazepines, with no repeat prescriptions in the short term.

Beta-blockers, such as propranolol are helpful as they relieve some of the causes of the physical symptoms of stress. These medications are generally not thought of as addictive and can be taken as needed.

By its very definition, Acute Stress Reactions or an acute stress disorder is a time frame condition. If symptoms last for longer, you should think about the diagnosis of PTSD. There are ways to help; often family and or community supports are enough.

If you like to speak with one of our psychologists, drop us a message. You can reach our friendly support team either via email, webchat or phone. We understand that the early stages of recovery from a traumatic event can be stressful. We will do our best to link you with the right clinician for you as quickly as possible.

Our own experiences and many success stories have made us believers of the telehealth platform. We believe that there is growing evidence showing online mental health support to be just as effective as in-person consultations. Armed with this knowledge, we work to bridge the gap between you and professional mental health support. Above all, we work through easily accessible technologies at your fingertips.

​Your comfort and convenience is our priority. We provide a comprehensive, continuous yet flexible platform to conduct telehealth. Given the higher rates of mental health issues in regional Australia, our team recognises that often those who are in need of mental healthcare assistance the most, find it difficult to reach out, faced with many barriers and obstacles.

Our telehealth platform aims to facilitate better mental health support, taking out travel costs, the commute, and long waitlists people in the regional areas of Australia often face. It is our vision to relentlessly exploit and pursue new technologies. And we bring quality healthcare to you, when you want it, where you want it, how you want it.