Suzanne Watson MD, MDiv, MEd

Del Mar Psychiatry


In-Person Appointments & Telemedicine Available, 317 14th Street, Suite D
 Del Mar, CA 92014

Acute Stress Disorder

Acute stress disorder (ASD) is a psychiatric condition that occurs after an individual experiences or witnesses a traumatic event, such as a death, crime, serious injury, accident, or threat of violence and then develops severe anxiety or other symptoms of psychological distress. Patients who develop ASD have experienced terror and helplessness during the event. This relatively newly defined condition has similarities to post-traumatic stress disorder (PTSD), but involves short-term symptoms that occur within a month of the traumatic event and last from a few days days to a month or less.

Risk Factors for Acute Stress Disorder

Some individuals are more likely to develop ASD than others. Certain inherited brain structures and hormone levels increase susceptibility to this disorder. Individuals who have been through other childhood trauma are also more likely to develop ASD, as are individuals who experience the precipitating traumatic event at an early age. People who are unstable, who lack strong support networks or who feel personally responsible for the event are also more vulnerable to developing ASD.

Symptoms of Acute Stress Disorder

Patients with acute stress disorder may experience a variety of symptoms including:

  • Dissociation
  • Depersonalization
  • Numbness or lack of emotional response
  • Recurring images, thoughts, dreams or flashbacks of the trauma
  • Partial loss of memory around the trauma (dissociative amnesia)
  • Sleep disturbances
  • Heightened anxiety, elevated startle response
  • Hyperarousal to stimuli reminiscent of the trauma
  • Avoidance of activities reminiscent of the trauma

Patients may be troubled by these symptoms sequentially or intermittently. If symptoms persist for longer than a month, the patient is typically diagnosed with PTSD. A large percentage of patients whose acute stress disorder is left untreated will develop PTSD. Apart from its limited duration, acute stress disorder is distinguished from PTSD by the fact that patients with ASD experience a greater sense of detachment from their surroundings.

Diagnosis of Acute Stress Disorder

Acute stress disorder is diagnosed after a thorough review of medical history and symptoms. In order to meet the criteria for diagnosis of this disturbance, patients must have at least three dissociative symptoms and other PTSD symptoms as well. Other causes for the patient's symptoms, such as substance abuse or a psychotic episode, must be ruled out.

Treatment of Acute Stress Disorder

Treatment for acute stress disorder usually involves cognitive behavioral therapy, which aims to change the patterns of thought about the traumatic event and to alter the patient's behavior in situations that cause anxiety. Undergoing cognitive therapy can also help this condition from developing into PTSD.

Other therapies for acute stress disorder include more traditional psychotherapy, psychological debriefing, family counseling, support groups and alternative relaxation therapies, such as meditation and yoga. Medication may also be prescribed to help treat acute stress disorder, usually in the form of anti-anxiety medications or antidepressants.

Additional Resources

Del Mar Psychiatry