Acute Stress Disorder: A Possible Response To Trauma

Medically reviewed by Melissa Guarnaccia, LCSW
Updated October 18, 2024by BetterHelp Editorial Team
Content Warning: Please be advised, the below article might mention trauma-related topics that could be triggering to the reader. Please see our Get Help Now page for more immediate resources.

The National Institute of Mental Health defines a traumatic event as “a shocking, scary, or dangerous experience that can affect someone emotionally and physically.” Examples include experiencing or witnessing an assault, a car crash, a natural disaster, war, or the sudden loss of a loved one. 

The way people react after living through a traumatic event can vary widely. Some may feel shaken and may ruminate on the event for a while after, but ultimately move past it without significant ill effects. Others may be deeply affected by the event, potentially developing a clinical mental illness as a result that may require treatment to resolve. Acute stress disorder (ASD)—not to be confused with autism spectrum disorder, which have the same acronym—is one reaction that some people may experience. Read on to find out more about what it is, how it’s diagnosed, and what to do if you’re experiencing symptoms. 

Trauma can be difficult to process alone

What is acute stress disorder?

Acute stress disorder is a type of acute stress response that usually manifests within a month of the experience of a traumatic event. According to the US Department of Veterans Affairs, it’s estimated to occur in anywhere from six to 33% of people who have lived through a traumatic event. It’s also more likely to occur in those who have previously experienced traumatic events, previously experienced post-traumatic stress disorder (PTSD), or have a history of other mental illnesses. Symptoms are usually similar to those of PTSD, such as:

  • Vivid and painful flashback memories

  • Nightmares

  • Intrusive thoughts

  • Hypervigilance

  • Feeling unsafe

  • Self-destructive behavior

  • Difficulty sleeping

  • Difficulty concentrating

  • Feeling numb or hopeless

Acute stress disorder can develop in response to actual or threatened traumatic events. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association, acute stress disorder may include dissociative symptoms, a negative mood, and efforts to avoid distressing thoughts or feelings related to the trauma. Trauma and stressor-related mental health conditions acute stress disorder highlight the intense emotional and psychological impact these events can have on individuals. Recognizing and addressing these symptoms early is crucial for effective mental health support and recovery.

Acute stress disorder vs. post-traumatic stress disorder

Though ASD and PTSD can both develop after a traumatic event, they have some differences. First, a diagnosis of PTSD requires a broader range of symptoms to be present than a diagnosis of ASD. Next, the other most important differentiator is time. Symptoms of ASD will manifest within a month of the individual experiencing trauma, while PTSD symptoms may not appear until three months after or more. Plus, symptoms of ASD last less than a month, while PTSD symptoms can go on for years if untreated.

Note that a person initially diagnosed with ASD can go on to receive a diagnosis of PTSD if their symptoms persist; this happens in about half of cases, per the American Psychiatric Association.

PTSD is a serious illness that typically requires therapy and/or medication to address.

DSM-5 diagnostic criteria for acute stress disorder

According to the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, the Fifth Edition (DSM-5), acute stress disorder is classified as a trauma- and stressor-related disorder. In order for a diagnosis to be considered, the individual must have experienced or witnessed something that meets the criteria for a traumatic event as detailed in the guidelines. They must also present with at least nine symptoms from any of the following five categories:

  • Intrusion symptoms, such as recurrent, involuntary, and distressing memories, dreams, or flashbacks to the event and/or marked distress in response to reminders of the event

  • Negative mood, namely the inability to experience joy, satisfaction, or loving feelings

  • Dissociative symptoms, such as an altered sense of reality or the inability to remember some parts of the event

  • Avoidance symptoms, or efforts to avoid memories or reminders of the event or things/people/places associated with the event

  • Arousal symptoms, like irritability, sleep problems, hypervigilance, and being easily startled

The DSM details that symptoms typically begin immediately after the trauma is experienced and must persist for anywhere from three days to one month for a diagnosis of ASD to be considered. It also notes that they must cause significant distress and/or trouble functioning, and that they must not be due to another condition or substance.

Other conditions ASD could lead to

It’s also worth mentioning that the experience of trauma and the development of ASD could eventually lead to the development of other challenges and conditions as well. It’s part of why seeking support after experiencing a traumatic event and especially if you’re showing signs of ASD can be so important. With the right intervention, you may be able to avoid developing another condition such as:

  • Depression

  • Panic disorder

  • Another type of anxiety disorder

  • A substance use disorder

Remember, you don’t have to be experiencing specific symptoms to seek help after living through some type of trauma. Virtually anyone can benefit from the compassionate, listening ear of a therapist after going through a difficult or frightening event, whether symptoms are present or not.

Trauma can be difficult to process alone

Treatment for acute stress disorder 

One of the most effective methods for healing from the effects of a traumatic experience—whether it takes the form of ASD, PTSD, or non-clinical effects of trauma—is therapy, which may or may not be recommended in conjunction with medication. Cognitive behavioral therapy (CBT) is one of the most effective modalities, especially trauma-focused CBT. The aim of this approach is to help the individual learn to recognize when distorted thoughts about the event, the world, or themselves are causing them distress. Over time, a cognitive behavioral therapist can then help them learn to shift these thoughts in a more realistic, positive direction.

As a result of this type of gradual cognitive restructuring, it can be easier to cope with signals your brain is sending so you can learn to feel happier, healthier, and more at peace. Additionally, it’s worth noting that research suggests that trauma survivors who receive some form of CBT treatment soon after the event are less likely to develop PTSD later. So if you’ve been through a traumatic event and are experiencing symptoms or simply would like someone to talk to about it, seeking the support of a licensed therapist who practices CBT could be beneficial.

Seeking online therapy for ASD

While seeking therapy is one of the most commonly recommended strategies for someone who has experienced or witnessed a traumatic event, not everyone feels comfortable meeting with a mental health care provider in person. Others may have trouble locating a provider near them or traveling to and from appointments regularly. Whatever the case may be, online therapy can represent a viable alternative in many situations. 

With a platform like BetterHelp, you can get matched with a licensed therapist who you can meet with via phone, video call, and/or online chat from the comfort of home or anywhere you have an internet connection. Research suggests that therapy—CBT in particular—is no less efficacious when delivered online than it is when delivered in person. That means you can generally feel confident in choosing whichever format works best for you.

Takeaway

Acute stress disorder (ASD) is a stress response a person could experience after going through or witnessing a traumatic event. Symptoms are generally similar to that of PTSD, which ASD can turn into in about half of cases. The recommended treatment for both is typically some form of psychotherapy conducted either online or in person.
Ease stress and mental exhaustion
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
Get the support you need from one of our therapistsGet started