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Acute Stress Disorder

Updated on June 14, 2012


Our brains are truly miraculous! Some of the most basic functions of the human brain are the abilities to react quickly in high stress, high danger situations in ways that preserve life. This reaction is reflexive, and happens extremely fast. And that is a good thing, too, because without that quick reaction to danger, our species may not have been able to survive the environments and situations that we found ourselves in as early humans.

Once danger is perceived by the human brain, multiple hormones and chemicals are released in the body that serve to activate muscles and reactions to preserve life. Among these chemicals is the aptly named 'stress hormone' called cortisol. Another chemical, more commonly known, is adrenaline, which is secreted by the adrenal glad, which lives in the vicinity of your kidneys. The end result is your ability to either run, fight, or play dead when danger comes close.

Following a dangerous situation that puts all of these chemicals into action, it takes some time for the body and brain to come back down to normal functioning. In fact, it make take several hours for the body's chemical levels to settle back to baseline. Many people have had the experience of being very frightened and taking hours to calm down afterward.

For some people, it takes even longer to regain a sense of calm and safety. This is likely due to a difference in their brain from those who can calm down and return to normal much quicker. The name for the cluster of symptoms for those who cannot calm down is Acute Stress Disorder. The signs of ASD include symptoms such as severe distress, intrusive memories of the trauma, feelings of being edgy and hyper-vigilant, nightmares, feelings of being numb or in shock, and difficulty in remembering details of the trauma, among others.

It is important to note that not all survivors of a trauma will experience all symptoms of Acute Stress Disorder; for some survivors, stress signs lessen considerably following the first few days after the dangerous and frightening event. Individuals prone to Acute Stress symptoms continue to have symptoms longer than a few days. Two people can experience the same trauma, and one may come out with severe stress that lasts for some time, while the other person may be fine in as little as a week.

It is also important to note that those individuals who are close to the survivor may also begin to experience Acute Stress symptoms. For example, a child who witnessed a parent in a situation or trauma that the child perceived as threatening to the parent's life may develop Acute Stress Disorder.

Over time, persistence of Acute Stress signs can become Post Traumatic Stress Disorder. But there may be ways of helping a survivor avoid having their ASD turn into PTSD, with counseling interventions.

There is some controversy over the ‘first aid de-briefing’ following a trauma. Some research finds that this is helpful; the theory being that the sooner treatment starts after the trauma, the more success in the long term in mitigating ongoing symptoms. In other studies, critical incident debriefing is found to have little helpful effect in the long term, but likely brings comfort to the survivor in the short term. In yet other studies, there is evidence that very rapid de-briefing following the trauma may in fact encourage longer term stress symptoms. In this counselor's experience, the sooner counseling help can be given, the better off the survivor tends to be, and the quicker the healing and return to normal functioning.

The truth of the value of rapid de-briefing somewhere in the middle. Each survivor is different, with different life experiences, strengths, supports, and views on life and the traumatic events, and so no one set formula can be claimed to be universal as a 'cure'. The best option, perhaps, is to allow the survivor to choose when the time is right for a trained professional in trauma counseling to speak with them. But they should speak to a professional counselor who is skilled in trauma counseling at some point in the not too far distant future from the time of the traumatic event. This professional will be able to assess how the survivor is doing as far as readiness to work through their trauma, levels of stress signs being presented, and recommend a course of treatment to the survivor to help them move through their plight toward healing.

There is no specific medication that treats Acute or Post Traumatic Stress Disorder, but there are medications that can help some symptoms like anxiety and depression that may result. There are several forms of counseling treatment available, including talk therapy, cognitive-behavioral restructuring, ‘flooding’, and Eye Movement Desensitization Reprocessing. 'Flooding' is an approach used often with battle hardened soldiers, whereby the details of the trauma are revisited multiple times until the details no longer carry the power to upset the survivor to such a high degree, and in the case of a soldier, help them understand and accept that there was nothing they could have done to avoid the traumatic event. Both ‘flooding’ and EMDR have their critics, as they are relatively new, and in the case of EMDR, much of the early research to back the claims of fast cures have been funded by EMDR proponents.

It is important for a survivor who has ASD to find a qualified and experienced counselor to help them.

Talk therapy and cognitive-behavioral restructuring are perhaps the most respected and most often used treatments, and can be quite effective if the counselor helping has experience in trauma treatment. There are generally four parts to the treatment, including: feeling safe again in all environments , sensitizing the victim to their triggering process of symptoms, educating the victim on how to make their own intervention when faced with triggers, and finally, stress inoculation. With adults, all four of these processes are worked on more or less simultaneously. Since each victim of trauma is different, this process to regain normal rhythms and functioning can take varying amounts of time. The wise counselor does not press a survivor to move any faster in the treatment than they are willing to go, because moving too fast can at least stall the healing progress, if not make it grind to a complete halt.

Recovery from Acute Stress Disorder is quite probable, given the motivation, courage, and proper counseling.

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    • visionandfocus profile image

      visionandfocus 5 years ago from North York, Canada

      You're absolutely right about the first-aid debriefing being controversial. Our survival instinct, the "fight/flight/freeze" response, is shared by the rest of the animal kingdom. Sometimes, a wildlife documentary will show a predator pouncing on its prey at the end of the chase. If you look closely, the prey often freezes when it realises it cannot out-run the predator and may even drop straight to the ground before contact with the predator. This playing dead releases a flood of endorphins to protect from the pain-to-come. Now if the predator is distracted and leaves without killing the prey, the latter will get up, and shake or tremble for a few seconds before running off. This is the discharge of the freeze response.

      In humans, we often stop this shaking/trembling before it has run its course, usually because it is distressing to the rescuer/observer. When we do so, a trauma capsule can form within the body and can cause the ASR to develop into PTSD. At least, this is one theory that I've come across and it is one that makes a lot of sense to me.

      Great write-up of an important issue. Voted up!

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