Acute Stress Disorder

Acute stress disorder (ASD) is the development of severe anxiety that occurs shortly after an extremely traumatic event such as death, threat to another person, or serious injury 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 from two days to 30 days. Anyone can develop ASD, but cannot be caused by drug use or any other condition. People with ASD can no longer function or socially interact as well at work or school as they did before the event. ASD can also lead to a trauma survivor not seeking help.

ASD versus PTSD

People with acute stress disorder are more likely to develop post-traumatic stress disorder (PTSD), which occurs when symptoms of ASD persist for more than a month. Studies have shown that more than 80% of people with ASD develop PTSD six months later, and even those who do not develop ASD may develop PTSD later. 

Studies show that a small number (4% to 13%) of survivors who do not develop ASD in the first month after trauma develop PTSD in later months or years. 

The symptoms of ASD and PTSD are similar.

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 (inability to remember details 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, rather than 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


There are no single laboratory tests or series of tests to detect an acute stress disorder. Your doctor can refer you to a mental health provider who will diagnose you based on your medical history, current signs and symptoms.


An acute stress disorder can become a long-term PTSD if not treated.

Cognitive-behavioral therapy (CBT)

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


Antidepressant anti-anxiety drugs have been effective in reducing the symptoms of ASD. Be aware that each person suffering from ASD may have different symptoms that would determine the appropriate medication.

How to Help

A trauma survivor may have difficulty talking about his or her experience because it is too painful. Therefore, be patient and understanding if he or she does not want to talk about this topic. Educate yourself about ASD or PTSD to gain an understanding of the behavior of your family member or friend. Observe what triggers flashbacks and frightened reactions and try to minimize the triggers within your control.

CHI Health Psychiatric Associates, with offices in Omaha and the surrounding area, has well-trained mental health providers who can address the needs of those suffering from acute stress disorder. If you think you or someone close is suffering from acute stress disorder, call (402) 717-HOPE.