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Acute Stress Disorder vs PTSD

Our lives are a culmination of moments, experiences, actions and feelings. They can be filled with laughter, tears, joy, heartbreak, peace, fear, health, sickness, comfort, loneliness, and a hundred emotional states that fall somewhere in between. That said, regardless of who you are, how much money you have, where you live, and what you do, we will all inevitably experience trauma, pain, loss, and death; be it physical or emotional pain, loss of a job, a romantic love, or a friend, or the death of a pet, a friend, family member, or spouse. These experiences are an unavoidable consequence of the human condition and our mortality; they are the flip side of the coin. Quite often, such events are shocking, unexpected and upsetting.

Few are mentally prepared or expect it when a traumatizing event springs up out of the blue, but because we are individuals, we all respond uniquely to traumatizing events. Two people can experience the same traumatic experience, and one might develop psychological trauma, while the other remains relatively unscathed. Such psychological issues can include acute stress disorder and post-traumatic stress disorder. Now, these two conditions share similarities or can result from the same event, however, it is essential to understand them individually and distinguish the differences between the two. Below, we will break down what both acute stress disorder and post-traumatic stress disorder are, how they form, and what can be done to treat them.

Psychological Trauma

There are a variety of things that we would refer to as traumatic, an argument with a friend, a messy break up of a long time romantic relationship, a failed test, a close, high stakes, loss of an athletic event, being fired from a job, a car accident, a significant injury, and the list goes on. While these may all seem to vary in severity, each one can create a lasting psychological impression. Even though there are countless researchers and experts within the field of psychology, there is not a clear consensus on what does or does not merit consideration as psychological trauma. In many ways, it is entirely subjective, especially since two people can have completely different reactions to the same traumatic experience.

Because this remains a contentious subject, the definition of trauma disorder has been debated fiercely over the years, which has led to changes or redefinitions. In a general sense, an official diagnosis of an individual dealing with psychological trauma would include the following:

  • A person who undergoes an experience that is exceedingly stressful and hard to overcome, and that generally involves pain, betrayal, loss, and/or an abuse of power
  • A person who deals with a sense of powerlessness in the face of the hard experience
  • An overwhelming feeling that the experience was a threat to their physical well-being, sanity or life itself
  • A feeling of being unable to cope with the memories and an inability to suppress the emotions it causes
  • A person who can no longer manage their daily routine or live a normal life in the face of that experience

The symptoms of psychological trauma can be both physical and emotional. While for most people such feelings dissipate over time, for some, the symptoms can be long-lasting, embedded deep in their psyche. Such symptoms can generally be broken up into four categories: behavioral, cognitive, physical and psychological.

Behavioral

  • Avoiding places, events, or activities that may bring back, or trigger memories or feelings of the event
  • Lack of passion or interest in things or activities once enjoyed
  • Socially isolating oneself from the world, avoiding those who do not understand the emotions or feelings of the trauma experienced
  • Adjustment disorder

Cognitive

  • Disorientation
  • Intrusive thoughts or memories of the event that seemingly pop up at random
  • Inability to concentrate
  • Lingering visual memories of the event
  • Memory loss
  • Nightmares that reoccur and cause someone to relive the event
  • Oscillating moods
  • Sense of confusion

Physical

  • Achy feeling through in muscles, joints, and bones
  • Altered sleep patterns
  • Being constantly on edge
  • Chronic muscle spasms or seizures
  • Constantly on edge
  • Erectile dysfunction
  • Exhaustion
  • Fatigue
  • Hyper-alertness, always wary of potential danger
  • Insomnia
  • Jumpy or easily scared
  • Lack of appetite
  • Sexual dysfunction or lowered libido
  • Tachycardia

Psychological

  • Anger
  • Angst
  • Anxiety Disorder
  • Depression
  • Emotional detachment
  • Emotional shock
  • Guilt, especially for those who survived an event where others died
  • Incredulity
  • Irritability
  • Overwhelming sense of fear
  • Obsessive-compulsive disorder
  • Panic attacks
  • Shame

Acute Stress Disorder

Acute stress disorder (ASD) is a mental disorder that can form during the first month following a traumatic experience. The most recent version of America’s diagnostic and statistic manual of mental disorders (DSM-5) states that the diagnosis of an acute stress disorder requires the following:

  • Criterion A.
    “Exposure to actual or threatened death, serious injury, or sexual violation in one (or more) of the following ways: Directly experiencing the traumatic event(s). Witnessing, in person, the events(s) as it occurred to others. Learning that the traumatic events(s) occurred to a close family member or close friend”
  • Criterion B.
    The presence of at least nine of the psychological trauma symptoms mentioned above that begin or get worse following the traumatic event(s)
  • Criterion C.
    The symptoms in criterion B. last for a duration that is at least three days and linger up to a month after exposure to the traumatic event(s)
  • Criterion D.
    The event results in clinically significant impairment or distress in occupational, social or various other areas of a normally functioning life
  • Criterion E.
    The issue is not a result of a medical condition such as a brain injury, or the result of substances such as alcohol, or medication

Quite often, acute stress disorder is a precursor to post-traumatic stress disorder. The Center for Disease Control found that more than 80% of people who develop ASD will also suffer from PTSD within six months. That said, not every single person who has ASD will necessarily have PTSD, and not everyone who develops PTSD has ASD. In fact, for somewhere between 4% and 13% of the PTSD population will not develop ASD in the initial month following the traumatic event(s). In these cases, they may develop PTSD months, if not years later.

While acute stress disorder can be caused by a variety of different types of events, some are more likely to result in ASD forming than others. For example, natural disasters such as floods, tornados, typhoons, or random events such as car accidents, result in a lower rate of ASD cases. On the other hand, those who survive violent experiences such as rape, sexual assault, robbery, physical assaults, and mass shootings are far likelier to result in ASD. This should not be all that surprising, since you are more likely to relive moments of horror, violation, and violence than, things that are caused maliciously by another person and that tend to alter one's worldview or views on humanity or life in general, rather than seemingly random occurrences, such as an earthquakes or car wrecks.

There are a variety of factors that can lead to someone having a higher risk of developing acute stress disorder after a traumatic event. They include:

  • Having previously undergone other traumatic events
  • Having a history of mental health issues
  • Having a history of PTSD in the past
  • Having PTSD symptoms that lead to a dissociative state as a result of traumatic or difficult events

Treating ASD

There are effective treatments for ASD, one of the most essential being cognitive behavioral therapy. Research has proven that those who start CBT immediately after a traumatic event are far less likely to develop symptoms of PTSD later on down the road. By addressing and discussing the issue, rather than suppressing it, a person can learn how to deal with the memories, pain, guilt and other problems associated with the traumatic experience.

Post-Traumatic Stress Disorder

Humans have likely been experiencing Post Traumatic Stress Disorder (PTSD) for thousands of years. Shellshock was the term described for World War 1 soldiers who spent months, if not years, experiencing the horrors of trench warfare. It was not an official psychological diagnosis until the 1980's, and it was not until the late 80's that the term included traumatic experiences such as serious illness, injury or child sexual abuse. Like Acute Stress Disorder, causes of PTSD can form for a variety of reasons, although the most common include: being in combat, witnessing death in combat, the sudden loss of a loved one, violence, sexual assault, crime, child abuse, the experience of a natural disaster, and regular exposure to trauma such as what occurs for EMTs, ER doctors, Policemen, and Firemen.

According to the DSM 5 to be diagnosed with PTSD a person must manifest the following criterion:

  • Criterion A.
    A person exposed to one of the following: death, threat of death, serious injury, threat of serious injury, sexual violence or assault, or threat of sexual violence or assault. This can be from direct exposure, witnessing the event(s), learning that a loved one or close friend was exposed to the traumatic event(s), indirect exposure to traumatic events (first responders, medics, etc.) and does not include through reading material or other forms of media
  • Criterion B.
    The presence of at least nine of the psychological trauma symptoms mentioned above that begin or get worse following the traumatic event(s) with at least one, if not more two, symptoms from each category mentioned
  • Criterion C.
    Negative feelings or thoughts that started or grew worse after traumatic event(s) this includes:
    1. Difficulty experiencing positive emotions
    2. Inability to recall key features of the trauma
    3. Overly negative thoughts about either oneself or the world
    4. Overexaggerated blame of others or oneself for being the cause of the trauma
    5. Negative Affect
  • Criterion D.
    Symptoms that last for longer than one month
  • Criterion E.
    The event results in clinically significant impairment or distress in occupational, social or various other areas of a normally functioning life
  • Criterion F.
    The issue is not a result of a medical condition such as a brain injury, or the result of substances such as alcohol, or medication

As should be quite apparent, PTSD is quite similar to ASD, except the symptoms can be harsher and have longer lingering effects on the psyche. It is normal to undergo something difficult and to have upsetting memories, a sense of edginess, difficulty sleeping and other such psychological responses to the event. It may even be difficult to go back to your normal routine afterward. However, the vast majority of people who undergo something possibly traumatizing will have those symptoms diminish as time passes. But, for those with PTSD, such symptoms can last months, years, if not entire lifetimes, especially if they are left unchecked and untreated.

What Treatments are Available for PTSD?

There are two usual types of treatment for PTSD, the first is psychotherapy, the second is medication, and most people dealing with PTSD will utilize both options to help fight their feelings of trauma.

Psychotherapy generally includes both one on one counseling and group counseling with a therapist and with others who also deal with similar issues. Three examples of effective psychotherapy are:

  • Eye Movement Desensitization and Reprocessing – Deals with focusing on hand movements or sounds as you discuss the traumatic events. This helps the brain focus on something else as it brings up and mulls over the traumatic event.
  • Cognitive Processing Therapy – In this, you learn skills that help you come to understand how the traumatic experience changed the way you think and feel. By altering the way one views the trauma, you can then alter how you feel about the event, especially in cases where one has survivor's guilt.
  • Prolonged Exposure – In this form, you talk about the traumatic experience multiple times, until you become desensitized to the event as a result of regular consideration and discussion. The more you talk about it, the less the memories upset you or can affect you. This includes going to places or doing things that you might have been avoiding due to fear of being triggered or reminded of the experience. By taking away their power, by reclaiming those spaces, one can gain control over the memories.

Medications for PTSD, specifically selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, regularly used for depression, are effective at fighting PTSD. Such medications include fluoxetine, paroxetine, sertraline, and venlafaxine. Trauma Informed care is also important in treated acute stress disorder or post traumatic stress disorder. Peaks Recovery offers trauma disorder treatment to help combat these issues. Visit or call Peaks Recovery today to learn more.