Acute Stress Disorder

Acute stress disorder (ASD) is the development of severe anxiety occurring shortly after an extremely traumatic event, such as witnessing the death, threatened death or serious injury to another person; or a threat to one’s personal integrity, such as rape or physical assault; or an event such as a natural disaster or robbery.

Acute stress disorder occurs within four weeks of the traumatic event and lasts two days to 30 days. Anyone can develop ASD, however it cannot be caused by drug use or another medical condition. Those with ASD cannot function as well at work or school or interact socially as before the event occurred. It also may keep a trauma survivor from asking for help.


Those who have acute stress disorder are very likely to get post traumatic stress disorder (PTSD), which occurs when symptoms of ASD a present for longer than one month. Research has found that over 80% of people with ASD have PTSD six months later. Also, those who do not get ASD can still develop PTSD later on. Studies indicate that a small number (4% to 13%) of survivors who do not get ASD in the first month after a trauma will get PTSD in later months or years. (Source: 

The symptoms of ASD are similar to post traumatic stress disorder (PTSD).  

Symptoms of Acute Stress Disorder

Dissociative Symptoms

While experiencing or after experiencing the distressing event, people with ASD have at least three of the following symptoms:

  • Feeling emotionally numb or detached
  • Feelings of unreality in one's sense of self (depersonalization)
  • Feeling disconnected from reality (Derealization)
  • Dissociative amnesia (cannot remember important aspect of the trauma)

Re-experiencing symptoms

The traumatic event is persistently re-experienced in at least one of the following ways:

  • Flashbacks— recurrent images, thoughts, dreams, illusions, including physical symptoms like a racing heart or sweating
  • Bad dreams
  • Frightening thoughts.

Avoidance Symptoms

Avoidance of anything that could cause recollections of the trauma (e.g., thoughts, feelings, conversations, activities, places, people).

  • Staying away from places, events, or objects that are reminders of the experience
  • Feeling emotionally numb
  • Feeling strong guilt, depression, or worry
  • Losing interest in activities that were enjoyable in the past
  • Having trouble remembering the dangerous event.

Hyperarousal symptoms

Hyperarousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event. They can make the person feel stressed and angry. These symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating. It’s natural to have some of these symptoms after a dangerous event.

  • Being easily startled
  • Feeling tense or "on edge"
  • Having difficulty sleeping, and/or having angry outbursts


No single laboratory test or series of tests are available to detect acute stress disorder. Your health care professional may refer you to a mental health provider, who will make the diagnosis from your history of symptoms, current signs and symptoms.


Acute stress disorder may become long-term PTSD if not treated.

Cognitive-behavioral therapy (CBT)

Cognitive-behavioral therapy (CBT) has been shown to have positive results. Research shows that those who suffer from acute stress disorder who get CBT soon after going through a trauma are less likely to get PTSD symptoms later. A mental health care provider trained in treatment for trauma can determine the best treatment plan.


Antidepressant anti-anxiety medications have been effective in reducing the symptoms of ASD. Be aware that each individual who suffers from ASD may exhibit different symptoms, which then would determine the appropriate medication.

How to Help

A trauma survivor may have difficulty talking about their experience because it is too painful, therefore be patient and understanding if he or she does not want to talk about this issue. Educate yourself about ASD or PTSD to gain an understanding of your family member or friend’s behavior. Begin to observe what triggers flashbacks and startled reactions and attempt to minimize the triggers in the home that you have control of. Remember, being supportive and understanding can make a big difference. Urge your friend or loved one to seek help.

CHI Health Psychiatric Associates, with offices in Omaha and surrounding areas, has highly-trained mental health providers who can address the needs of those who suffer from acute stress disorder. If you think you or a loved one may be suffering from acute stress disorder, call (402) 717-HOPE.