What is an Acute Stress Reaction?

The answer lies in the name itself. “Acute” is short term or not long-lasting. “Stress reactions” are the physical and psychological symptoms. They are the result of the traumatic event. The stressor or traumatic event could be an accident, personal violence or other hurtful events. Other terms for acute stress reaction are acute stress disorder, crisis state. 

How are everyday life stressors different from an acute stress reaction?

Experts disagree on what qualifies as a trigger for an Acute Stress Reaction. How stressful does the event need to be? Firstly, the diagnosis came about to help identify and understand people who had psychological symptoms immediately after a trauma. In addition, separate acute reactions to more chronic conditions such as PTSD.

An acute stress reaction follows a notable traumatic event. For instance, natural disaster, sexual assault or physical violence. Whereas everyday life stressors come up due to the cumulative effects of overwork, busy home lives, exams or other chronic issues we face.

What are the symptoms of an acute stress reaction?

Symptoms of an acute stress reaction develop soon after a traumatic event and can last for weeks. Often they settle soon after. 

Psychological symptoms:

  • Flashbacks, nightmares and intrusive memories
  • Avoidance of reminders
  • Dissociation
  • Poor memory and concentration
  • Anxiety and mood changes
  • Feeling emotionally numb, detached from others
  • Reckless or aggressive behaviour

Physical symptoms:

  • Sleep disturbances
  • Nausea or an upset stomach
  • Chest pain, headaches, difficulty breathing

Everyone processes trauma in a different way. No two people experience trauma the same way. 

Telling apart an Acute Stress Reaction from other related disorders

  • Adjustment disorder

They both can occur soon after a difficult situation. However, adjustment disorder can occur after an adverse event and not necessarily a traumatic one. Whereas to qualify for a diagnosis of acute stress reaction the event has to be traumatic. 

Timeframes in particular are also relevant. A diagnosis of adjustment disorder can be made within 6 months of the stressor, whereas a diagnosis of Acute stress reaction has to be made within the first month. 

  • Depression 

A traumatic event may lead to depressive symptoms. Depression is persistent low mood, lack of interest and hopelessness. In addition, guilt, feeling tired and other depressive symptoms that last for more than a couple of week. However, a way to tell depression apart from an Acute Stress Reaction is that depression involves repetitive thinking patterns. Whereas 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

  • Dissociative episodes

It is not that uncommon for people following traumatic events to present with dissociative symptoms, derealization or amnesia. The care for people diagnosed with either depersonalisation or derealization disorder is different to an acute stress reaction. Therefore, detailed history taking by a clinician will help tease the two conditions apart. 

  • Drug use

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

What increases your risk of developing Acute Stress Reaction

Acute Stress Reaction as a 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. Past trauma can leave behind unresolved issues. 
  • 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. 

How common is 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:

  • motor vehicle accidents,
  • head injuries,
  • personal injuries,
  • work accidents, 
  • terrorist attacks. 

Diagnosing Acute Stress Reaction

Acute Stress Reaction is listed in the World Health Organization (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
  • When psychological symptoms of trauma last for longer than 1 month a diagnosis of PTSD should be considered.
  • The condition is characterized 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 complete checkup. They will want to know a bit about the traumatic events and supports you have. In addition, whether you feel safe, your past mental health and other aspects. 

Treatment

Often times no professional treatments are indicated. 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

Often times 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 and legal supports

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

Psychology

Trauma-based supportive therapy and cognitive behavioural therapy can help. These treatments work by learning about trauma responses, ways to reduce anxiety and stop unhelpful thoughts. 

Exposure therapy is used quite heavily in PTSD; therapists are using aspects of it when managing acute stress reactions. Exposure can be done by imagination but also in person. Exposure work is often started in session with a therapist before being done by oneself. In addition, tape recordings, videos are used to help with imagination exposure work. 

Online supports

Finally, there are increasing numbers of online therapy modules for trauma. Plus there are peer support groups and educational resources.

Medication

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

Benzodiazepines are classified as sedating medication. The WHO published articles cautioning benzodiazepine use in the first month after trauma. 

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

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

Recovery from an Acute Stress Reaction

By its very definition, Acute Stress Reactions or an acute stress disorder is a time-limited condition. If symptoms last for longer, a diagnosis of PTSD should be considered. There are ways to help; often family and or community-based supports are enough. 

If you would 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 in with the right clinician for you as quickly as possible. 

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