An acute stress reaction typically occurs after an unexpected life crisis, such as a serious accident, sudden bereavement, or other traumatic event.
What is an acute stress reaction?
An acute stress reaction occurs when a person experiences certain symptoms after a particularly stressful event. The word 'acute' means the symptoms develop quickly but do not 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. Acute stress reactions may also occur as a consequence of sexual assault or domestic violence.
Acute stress reactions have been seen in people who experience terrorist incidents, major disasters, or war. Military personnel are at more risk as a result of extreme experiences during conflicts.
An acute stress reaction usually resolves within 2 to 3 days (often hours).
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What are the symptoms of an acute stress reaction?
Symptoms usually develop quickly over minutes or hours - reacting to the stressful event. 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 reaction?
Acute stress reaction is no longer considered to be a mental health disorder. There is no set timeline for grief or response to stressful events, and many of the symptoms described above are to be expected. No treatment for acute stress reaction may be needed, as symptoms usually go once the stressful event is over and usually within a few days. Understanding the cause of the symptoms, or talking things over with a friend or family member, may help.
When does an acute stress reaction become a mental health problem?
If symptoms of an acute stress reaction last longer than three days but less than a month, this is called an acute stress disorder (ASD). Acute stress disorder is not universally recognised as a medical condition and what you are experiencing may still be a normal or appropriate response for you, in your circumstances. However, if you are struggling, one or more of the following may help:
Self-care and practical support
If necessary, ensure that you are physically safe. Talking things over with family, friends, or a professional can help. Regular exercise, healthy diet, regular sleep, and limiting caffeine and alcohol are good for your general mental health.
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.
You may wish to contact your doctor or other healthcare professional for practical support, connection with social support, information about self-care and coping strategies, or referral for psychological therapies.
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. It is the treatment of choice for acute stress disorder.
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. Some organisations specialise in bereavement counselling.
However, not everyone needs to process trauma as soon as possible after the incident. Indeed, interventions such as Psychological Debriefing immediately after trauma or critical incidents can make things worse, and are not recommended.
Generally, medications are not as effective as psychological therapies in treating acute stress disorder and should not routinely be used.
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.
Sometimes, medications are given to help with specific problems like lack of sleep, pain, or depression, but you should discuss these with your doctor.
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.
Further reading and references
Bryant RA; Acute stress disorder. Curr Opin Psychol. 2017 Apr14:127-131. doi: 10.1016/j.copsyc.2017.01.005. Epub 2017 Jan 18.
Kavan MG, Elsasser GN, Barone EJ; The physician's role in managing acute stress disorder. Am Fam Physician. 2012 Oct 186(7):643-9.
Anxiety disorders; NICE Quality Standards, Feb 2014
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.
Rose S, Bisson J, Churchill R, et al; Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2002(2):CD000560.