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While most people are at least somewhat familiar with PTSD (posttraumatic stress disorder), few have heard of a very similar anxiety disorder called Acute Stress Disorder (ASD).
In fact, it often precedes the development of PTSD. Like PTSD, ASD is triggered by exposure to a traumatic event that evoked significant fear or horror and/or a sense of helplessness.
Traumatic events that lead to ASD (and PTSD) in many people may include witnessing a violent assault, injury, or death; being in combat or experiencing a natural disaster (e.g. a hurricane or tornado); being seriously injured or nearly dying in an accident or assault; or being raped, mugged, or abducted. Acute stress disorder may also develop after finding out that a loved one has died unexpectedly or violently, was seriously harmed, or that the loved one’s life was threatened.
The primary difference between PTSD and ASD involves the timeframe within which the symptoms develop and how long they last. In ASD, the symptoms appear within 4 weeks following the event. They last at least 2 days and no longer than 4 weeks. In PTSD, however, the symptoms must last for at least a month. They may start weeks or months after the event and can last for months or even years.
The symptoms of ASD must include:
Dissociation – One of the primary symptoms of ASD, dissociation involves a disturbance in your memory, identity, awareness, and orientation. With ASD, the dissociation may take place while you’re actually experiencing the traumatic event or at some point after it’s over. At least three of the following dissociative symptoms must occur:
Reliving the Trauma - Another major symptom of ASD involves reliving the traumatic event over and over in some way or several different ways, such as:
You may also become very anxious or distressed if you are faced with anything that reminds you of the event.
Avoidance - With ASD, you will go out of your way to avoid anything that triggers memories of the trauma, such as people or places that you associate with it, talking about it, or thinking about it. You may also avoid any type of related activity, such as swimming or boating (for example) if you had almost drowned. Feelings about the event are also often suppressed or numbed (e.g. with alcohol, food, or drugs) as they can be far too painful or scary.
Anxiety / Hyperarousal - Acute distress disorder is categorized as an anxiety disorder because anxiety (or hyperarousal) is a key symptom. Hyperarousal may manifest in a variety of ways, such as having problems sleeping, being easily startled, feeling restless or irritable, or having a hard time concentrating. Sometimes people with ASD become hypervigilant.
The symptoms of ASD are serious enough to cause significant distress and interfere with your ability to function in various aspects of your daily life. They can even interfere with your ability to seek much-needed help or let your loved ones know about the trauma you’ve endured.
While anyone is vulnerable to developing ASD following a traumatic experience, some people have a greater risk than others. Factors that increase the risk include:
As with most psychiatric disorders, there are no blood tests or other specific tests used to diagnose ASD. It’s diagnosed by a mental health or medical professional based primarily upon the symptoms that appear following a traumatic event. It’s not unusual for a spouse, family members, or close friends to notice the symptoms first and encourage or insist upon an evaluation.
Appropriate treatment can help significantly reduce and alleviate symptoms of ASD in most cases. The best time to seek treatment is as soon as the symptoms begin to appear. If the symptoms are ignored or treatment is delayed, it increases your risk of developing posttraumatic stress disorder.
Treatment for ASD may include psychotherapy, medication, or a combination of the two. While medication can help reduce some symptoms, such as anxiety, nightmares, and poor sleep, therapy often provides more lasting results and can decrease the risk of developing PTSD.
Medications that may be prescribed to help with symptoms may include benzodiazepines, antidepressants, and antipsychotic drugs. One particular hypertensive medication – prazosin – is sometimes prescribed to help with insomnia and recurrent nightmares.
Cognitive behavioral therapy and exposure therapy are often used to treat ASD. Other therapies may also be very beneficial, such as EMDR (eye movement desensitization and reprocessing) or other types of talk therapy.
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