Acute Stress Disorder

What is Acute Stress Disorder?

Acute stress disorder is distinguished by the development of severe anxiety and it typically occurs within four weeks of a traumatic or distressing event. It generally lasts for at least three days and can continue for up to one month.

Individuals with ASD experience a decline in emotional responsiveness, feeling guilty about pursuing normal life tasks. They also find it difficult to enjoy their usual hobbies or regular activities. The symptoms that define acute stress disorder overlap with those of PTSD.

However, those with ASD are more likely to feel detached from their bodies and a PTSD diagnosis cannot be given until symptoms have lasted at least one month.

Studies of acute stress disorder suggest that between 6% and 33% of people who experience a trauma develop ASD. However, rates differ for different types of traumatic events. For example, survivors of violence (assaults, robberies, mass shootings) show higher rates, whereas survivors of accidents or natural disasters show lower ASD rates.

Acute Stress Disorder Symptoms

Dissociative symptoms

Individuals suffering from ASD show three or more dissociative symptoms. These symptoms include:

  • Feeling detached, numb or being emotionally unresponsive
  • Reduced awareness of their surroundings
  • Depersonalization – the survivor’s emotions or thoughts do not seem real
  • Derealization – the survivor’s environment seems strange or unfamiliar
  • Dissociative amnesia – the individual cannot remember important aspects of the traumatic or distressing event

Re-experiencing the trauma

Individuals with ASD will persistently re-experience the dramatic event in one or more ways. These include:

  • Experiencing recurring thoughts, nightmares, images, flashback episodes or illusions
  • Feeling like they are reliving the event
  • Feeling distressed when they are reminded of the trauma


It is common for those with ASD to avoid stimuli that may cause them to re-experience or remember the traumatic event. Stimuli include:

  • Conversations
  • People
  • Objects
  • Places
  • Feelings
  • Thoughts
  • Activities


The symptoms of acute stress disorder may disrupt important aspects of an individual’s life or cause distress.

This includes work or social settings, as well as the inability to complete tasks or tell others about the trauma.

Anxiety or increased arousal

Other symptoms of ASD include increased arousal and anxiety.

Symptoms can range from having trouble sleeping to feeling irritable, not being able to sit still, having difficulty concentrating, being tense or on guard constantly, and being easily startled.

Acute Stress Disorder Causes

Acute stress disorder can be caused by witnessing, experiencing or being confronted with one or more traumatic events. These events can create intense horror, helplessness or fear.

Traumatic events include:

  • Death
  • A threat of death
  • A threat of serious injury
  • A threat to physical integrity

To be at risk of ASD, a person must be exposed to a traumatic event. However, individuals who have previously been diagnosed with a mental disorder may be at a greater risk of developing acute stress disorder.

Those who perceive the traumatic event to be severe, have a history of previous trauma or have an avoidant coping style when dealing with distress may also be at greater risk of developing ASD. Women are more likely to develop ASD than men.

Acute stress response is the physiological response behind ASD. When a threatening or fearful event is recognized, humans experience an automatic response geared towards either fleeing or confronting the threat (fight-or-flight response).

The hallmarks of ASR are an instantaneous surge in blood pressure, sweating, heart rate, breathing and metabolism. People experience acute stress response more frequently when they perceive a danger or threat in their environment.

Acute Stress Disorder Treatments

Acute stress disorder is treated using one or more of the following methods:

  • A psychotic evaluation
  • Hospitalization if the survivor is at risk of suicide or hurting others
  • Psychiatric education to teach the survivor about the disorder
  • Medication to relieve any symptoms (anti-anxiety medications, antidepressants, selective serotonin reuptake inhibitors)
  • Cognitive behavioural therapy – this can increase recovery speed and may prevent ASD turning into PTSD
  • Help locating family and obtaining food, shelter and clothing, if necessary
  • Hypnotherapy or exposure-based therapies

Acute Stress Disorder Prevention

Because there is no way to guarantee an individual will never experience a traumatic event, ASD cannot be prevented. However, there are ways to reduce the likelihood of survivors developing acute stress disorder.

For example, getting medical treatment within a few hours of the trauma can reduce the likelihood of ASD developing.

Those that work in jobs that carry greater risk of experiencing traumatic events, such as military personnel, may benefit from counseling and preparation training to reduce the risk of both ASD and PSTD. Counseling and training may include fake enactments and learning coping mechanisms.


People with ASD are normally diagnosed with PTSD. This diagnosis is made when a survivor’s symptoms persist for more than a month and they are experiencing a significant amount of stress.

Last Reviewed:
September 12, 2017
Last Updated:
April 07, 2019
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