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Acute Stress Disorder | What You Need to Know

Acute Stress Disorder | What You Need to Know


Many of us have experienced traumatic events at some point our lives. In addition to the pain of losing a loved one, 1 in 4 women have been a victim of rape or attempted rape, and each year, 1 million children suffer from abuse or neglect. In the United States alone, statistics show that 7 percent of men and 22 percent of women are either physically or sexually mistreated, three quarters of a million were robbed, millions of children are bullied, and 3 million people have been in car accidents every year.

Survivors of such traumatic events, along with people close to them, are prone to emotional instability and may develop dissociative symptoms that occur in the first month after exposure to an extreme trauma. If you have faced any traumatic event, such as a serious injury that interrupted or threatened your life, the death of a loved one, or the experience of a natural disaster, you are at risk for acute stress disorder. Here are the important things you need to know about the disorder.


A Better Understanding of Acute Stress Disorder

The medical definition of acute stress disorder (ASD) describes the condition as the anxiety and behavioral turmoil that develop in a month’s time following a traumatic event. When faced with traumatic events, the automatic reactions are survival-based. The tendency is to process and understand such events to figure out how they fit into the life picture.

Unfortunately, there may be situations when the trauma responses are not adaptive. Instead of moving forward, the disturbing and unexpected event may cause acute stress that usually results in fear or pain and may leave you stuck in the trauma. This acute stress reaction or acute stress disorder involves dissociative symptoms that reflect a perceived detachment of the mind from its emotional state and physical body. The feeling is characterized by a dreamlike sense of self and the world as an unreal place, and is often accompanied by poor memory of the specific event. Its severe form, known as dissociative amnesia, can result in your feeling helpless.

Acute stress disorder is a variant of post-traumatic stress disorder (PTSD), thus their symptoms typically overlap. The difference lies on the manner in how they persist. With an ASD, the symptoms often manifest approximately within hours to days following the traumatic event. The symptoms typically begin to subside in a week or upon removal of the stimulus. If the symptoms are associated with functional impairment or significant distress that persists for at least a month, the diagnosis is changed to PTSD.

Research indicates that ASD is a high risk for developing PTSD. More than 80 percent of people diagnosed with the disorder may develop PTSD within six months, but there can be exceptions. Although there appears to be a correlation between ASD and PTSD, the latter can develop even if you do not have acute stress disorder. On the other hand, you are more likely to develop ASD if you were previously diagnosed with PTSD.


Critical Features of Acute Stress Disorder

DSM-IV Diagnostic Criteria for acute stress disorder involve the development of transient emotional, cognitive and behavioral symptoms in response to an overwhelming traumatic event that present a serious threat to the security or physical integrity of a person or of a loved one.

ASD is characterized by the presence of the following symptoms:

Initial “dazed” state – An altered sense of the reality of one’s surroundings or oneself disables you to fully comprehend the stimuli. This “dazed” state is accompanied by a shortened attention span, disorientation, poor memory, decreased consciousness, and delayed reaction, resulting in difficulty to recognize the reality of the traumatic experience. The “dreamlike” state may cause you to dissociate and withdraw from your surroundings, and it is not uncommon to have vague memories of the specific details or aspects of the event.

Withdrawal and/or extreme anxiety – The tendency to withdraw or experience extreme anxiety immediately follows the “dazed” state. You may feel confused and isolate yourself. In this period, you may display irritable behavior and angry outbursts, hypervigilance and/or agitation, and an exaggerated startle response, which may be followed by severe depression. Some specific symptoms related to this include panic attacks, accelerated heartbeat, flushing, excessive perspiration, sleep disturbance and problems with concentration.            

Flashbacks – With ASD, it is common to regularly relive some parts of the event, as if it is happening again. The persistent, involuntary, intrusive and upsetting memories may be in the form of nightmares and/or thoughts in which you may feel or perceive reliving the traumatic event all over again. The flashbacks may cause you to start avoiding any place or stimulus that symbolizes or resembles an aspect related to the traumatic experience.

For the condition to be classified as acute stress disorder, the symptoms must occur within minutes of the stressful event and must persist anywhere from at least 48 hours to one month after the traumatic experience. There is usually the presence of complete or partial amnesia during an ASD episode.


The Prevalence of Acute Stress Disorder

Anyone can be susceptible to develop the symptoms of ASD after the occurrence of a traumatic event. There are, however, certain factors that increase the risks, including:


  • The seriousness and type of trauma, whether induced or non-intentional
  • Lack or inadequate support systems
  • Pre-existing psychological, emotional or behavioral health issues
  • Previous trauma
  • Substance abuse
  • Interpretation of the traumatic event
  • Perceived harm
  • Negative effect such as anxiety, depression, guilt, helplessness, hopelessness, etc.
  • High levels of pain experienced
  • Gender related trauma


The DSM-5 provides information that ASD has a variable rate of frequency in individuals exposed to traumatic events. In general, it can be caused by a variety of stressful situations in life. Depending on both the nature and context of the event, variations can range from a 6 to 50 percent rate of occurrence of ASD in trauma victims. Different types of traumatic events can elicit different types of responses. Within and outside the United States, it appears that ASD has the following rates of occurrence:


High occurrence of ASD, ranging from 20 to 50 percent, for survivors of interpersonal traumatic events, such as robberies, rape, or mass shooting

19 percent of assaults

14 percent of mild traumatic brain injuries

13 to 21 percent of motor vehicle accidents

10 percent of severe burns

6 to 12 percent of industrial accidents


Help and Treatment Is Available

Acute stress disorder is an all-consuming behavioral health condition that can negatively impact your many aspects of your life. It is not a weakness, but a reaction to an external trauma. It can seemingly turn your world upside down, with symptoms that can result in your feeling trapped in the trauma. Fortunately, it is treatable, and seeking out a professional can help you live a full life again.

In some cases, the disorder can resolve itself with time. Research shows, however, that therapy can help accelerate the recovery process. Many patients who seek treatment for acute stress disorder are at lower risk of developing post-traumatic stress disorder in the future. If you or someone you know is suffering from the symptoms of ASD, you may benefit from counseling as the right intervention in restoring order out of chaos created by a traumatic event.

Whether you have ASD or PTSD, resources are available on how therapy can help you resolve your issues and move forward in life. At Carolina Counseling Services – Cameron, NC, on Hwy 87, near Linden Oaks, there are independently contracted highly-trained professionals who specialize in addressing the needs of those who suffer from acute stress disorder. When you call to request an appointment, you will be matched with the right fit therapist who can treat you appropriately. Make the call today!

Serving Areas: Carolina Counseling Services – Cameron, NC

Counties: Harnett County

Areas: Cameron NC, Linden Oaks NC, Sprout Springs NC, Anderson Creek NC, Olivia NC, Pineview NC, Johnsonville NC, Spring Lake NC

Zip Codes: 28326, 28327, 27332, 28394

Rose Thomas, MA, LPC, LCAS, NCC

Specializes in: (Ages 5+) Children, Teens, Individuals, Couples and Families. Anxiety, Depression, ODD (Oppositional Defiance Disorder, ADHD, Relationship Issues, Marriage Counseling, Parenting, PTSD/Trauma Recovery, Acute Stress Disorder, Adult Sexual Abuse Survivors, Adjustment Disorders, Depressive Disorders, Persistent Depressive Disorder, Bipolar and Related Disorders, Self-injurious/Self-Harm, Generalized Anxiety Disorder, Panic Disorder, Agoraphobia, Separation Anxiety, Disruptive Disorders, Conduct Disorder, Marital Conflict and Discord, LGBT, Substance Use Disorders
 Insurance: BCBS, Tricare, Tricare Prime, Tricare Select, Extra, Retired, Cash, HSA and FSA accepted (credit cards accepted)
 Credit Cards: Visa, Mastercard, Discover and American Express


Specializes in: (Ages 4+) Children, Individuals, families, PTSD, Trauma, Eye Movement Desensitization and Reprocessing (EMDR) Adjustment Disorder, ADHD, Depression, Anxiety, communication skills, and Parenting Skills, Behavior Management, Life transitions, Family Conflict, Difficulty Coping, Relationship Problems, Depression, Anxiety

InsuranceBCBSTricare, Cash, HSA and FSA accepted and Apple Pay

Credit cards:  


Shirlisa Daniels, MS, LPC, NCC

Specializes in: (Ages 4+) Children, Teens, Adults and Individuals, Families, Anxiety Disorders, Depression, Panic Disorder, Bipolar Disorder, ADHD, ODD, PTSD, Relationship Issues, Conflict Resolution and Life Transitions
Insurance: BCBS, Tricare, Cash (credit cards accepted)
 Credit Cards: Visa, Mastercard, Discover and American Express

Holly Ring, LMFT

Specializes in: (Ages 7+) Adolescents, College Students, Individuals, Couples, and Families, Anxiety, Depression, Trauma (child and adult, TFCBT certified), Relationship Issues, Coping Skills, Adjustment Disorders, Life Transitions, Suicidal Ideation, Self-esteem, OCD, ADHD, Behavioral Issues, Parenting Skills, LGBTQ
Insurance: BCBS, Tricare, Cash (credit cards accepted)
 Credit Cards: Visa, Mastercard, Discover and American Express

How Do I Set Up my FIRST Appointment?

  • Call: (910) 716-8006 (Fastest way to schedule)
  • Text: (910) 308-3291 (Reply will be via phone)
  • Click here and use our Contact Form (You must include your phone number, because replies will only be made by telephone to ensure security/privacy)
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  • Appointment scheduling for NEW clients: Mon-Fri 8:30am-5:15pm
  • New client appts may be scheduled when therapists have openings, which may include daytime, evenings and weekends.
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  • Referrals: MOST beneficiaries do NOT need a Referral!
Carolina Counseling Services - Cameron, NC
35 Plantation Drive, Suite 100B and 100C
Cameron, NC 28326

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PO BOX 9909
Fayetteville, NC 28311

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