What is an acute stress reaction?
An acute stress reaction occurs when symptoms develop due to a particularly stressful event. The word 'acute' means the symptoms develop quickly but do not usually last long. The events are usually very severe and an acute stress reaction typically occurs after an unexpected life crisis. This might be, for example, a serious accident, sudden bereavement, or other traumatic events. Road traffic accidents cause many casualties each year and you may be directly or indirectly affected by this kind of exceptionally stressful event. Acute stress reactions may also occur as a consequence of sexual assaults or domestic violence.
Acute stress reactions have been seen in people who experience terrorist incidents or major disasters. They may also occur in people who experience war in their countries. Military personnel are at more risk as a result of extreme experiences during conflicts.
What are the symptoms of an acute stress reaction?
Symptoms usually develop quickly over minutes or hours - reacting to the stressful event. They usually settle fairly quickly but can sometimes last for several days or weeks. Symptoms of acute stress reactions may include the following:
- Psychological symptoms such as anxiety, low mood, irritability, emotional ups and downs, poor sleep, poor concentration, wanting to be alone.
- Recurrent dreams or flashbacks, which can be intrusive and unpleasant.
- Avoidance of anything that will trigger memories. This may mean avoiding people, conversations, or other situations, as they cause distress and anxiety.
- Reckless or aggressive behaviour that may be self-destructive.
- Feeling emotionally numb and detached from others.
- Physical symptoms such as:
- A 'thumping heart' (palpitations).
- A feeling of sickness (nausea).
- Chest pain.
- Tummy (abdominal) pains.
- Breathing difficulties.
The physical symptoms are caused by stress hormones, such as adrenaline (epinephrine), which are released into the bloodstream, and by overactivity of nervous impulses to various parts of the body.
What are the treatments for acute stress disorder?
No treatment may be needed, as symptoms usually go once the stressful event is over and you deal with it. Understanding the cause of symptoms and talking things over with a friend or family member, may help. However, some people have more severe or prolonged symptoms. One or more of the following may then help:
Cognitive behavioural therapy (CBT)
CBT is a talking therapy and is based on the idea that certain ways of thinking can trigger or fuel certain mental health problems. The therapist helps you to understand your current thought patterns. In particular, to identify any harmful, unhelpful and false ideas or thoughts. The aim is then to change your ways of thinking in order to avoid these ideas and help your thought patterns to be more realistic and helpful. When it is used for acute stress reactions it is known as trauma-focused CBT.
This may be an option if symptoms are persistent or severe. Counselling helps you to explore ways of dealing with stress and stress symptoms. This may be available locally but some charities also offer online resources and helplines that may be useful.
Taking a medicine may be an option:
- A beta-blocker is one medicine that can help relieve some physical symptoms that are caused by the release of stress hormones. Beta-blockers are not addictive, are not tranquillisers and do not cause drowsiness or affect performance. You can take them as required.
- Diazepam is a benzodiazepine tranquilliser. These are very rarely used and are reserved for exceptional cases for very short periods. It is addictive and will quickly lose its effect when taken for more than a few days.
What if my symptoms persist?
Some people who have an acute stress reaction will find their symptoms persist for longer than one month. It may be necessary to discuss these symptoms with your doctor. There may be another explanation for your symptoms. Some people with long-term symptoms may need to be assessed to see if post-traumatic stress disorder is a possibility.
Although alcohol may apparently give short-term relief of symptoms it can be damaging. Drinking alcohol to 'calm nerves' may lead to problems with low mood, worse anxiety and problem drinking and is not recommended.
Further reading and references
Anxiety disorders; NICE Quality Standards, Feb 2014
Computerised cognitive behaviour therapy for depression and anxiety; NICE Technology Appraisal Guidance, February 2006 (last updated May 2013)
Rahnama M, Shahdadi H, Bagheri S, et al; The Relationship between Anxiety and Coping Strategies in Family Caregivers of Patients with Trauma. J Clin Diagn Res. 2017 Apr11(4):IC06-IC09. doi: 10.7860/JCDR/2017/25951.9673. Epub 2017 Apr 1.
19 year old female with 5 year history of eating disorder, recently anorexia, and excessive workout.Stopped due to chest, arm and jaw pain that made me think I was going to have a heart attack....elizabeth 09848
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