Acute Stress Disorder: Symptoms to Watch For

Mary Lucas, RN

Reviewed by Mary Lucas, RN

Written by Our Editorial Team

Published 02/24/2022

Updated 02/25/2022

Sure, we all experience stress — but there are some forms of stress that can overtake our lives.

One of those forms of more serious stress is acute stress disorder.

In this article, we’re going to break down for you what constitutes the mental disorder known as acute stress disorder — its causes and effects — as well as how to properly treat it.

Read on to learn more.

What Is Acute Stress Disorder?

Acute stress disorder (ASD) is a mental health illness that can occur within the first several months of a traumatic event.

According to the data, survivors of a traumatic incident report acute stress disorder between six percent to 33 percent.

The symptoms of acute stress disorder are similar to the symptoms exhibited by those who suffer from posttraumatic stress disorder, or PTSD.

There is notable variation in the forms of acute stress disorder people experience. The difference occurs in relation to the traumatic event the person afflicted with acute stress disorder undergoes.

For example, those who’ve survived accidents or natural disasters report a lower rate of acute stress disorder compared to those who’ve survived an instance of a mass shooting, domestic violence (such as a physical or sexual assault), a robbery or a shooting of some kind — whether in a combat zone, a terrorist attack or otherwise.

What differentiates acute stress disorder from post-traumatic stress disorder is acute stress disorder is measured within the first few weeks (no more than four) after a traumatic episode.

If the symptoms of acute stress disorder do not abate, the mental health challenge morphs into being classified as post-traumatic stress disorder.

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How Do You Diagnose Acute Stress Disorder?

According to the American Psychiatric Association, there are several criteria required to distinguish acute stress disorder from other reactions to traumatic events.

First, you must find underlying exposure to the traumatic episode or event. Underlying exposure lays the groundwork for having ASD. 

The traumatic incident can vary from sexual, to physical and violent. 

Another form of trauma that can lay the groundwork for this mental health care challenge is emotional abuse.

Once established that the person with ASD has this underlying, pre-existing exposure, medical professionals then check if they have at least eight symptoms from any of of the following clusters of symptoms:

Intrusion Symptoms

Intrusion symptoms occur when distressing memories of a devastating, traumatic event continually surface.

The continual resurfacing of these nasty memories manifests in painful ways, both psychologically and physically.

Further, atop the continual resurfacing of traumatic memories and the physical and emotional distress they cause, intrusion symptoms can also come in the form of nightmares and flashbacks.

Negative Mood

Commonly, professionals identify someone with a “negative mood” as being unable to feel success, love or a general form of joy. 

Happiness and affection for someone with a negative mood are challenging, even downright impossible.

Dissociative Symptoms

When you have dissociative symptoms, you have the feeling that you cannot attach to yourself or your feelings.

Dissociation is the disturbance of or interference with at least one mental function.

Dissociative amnesia can also be a symptom that falls under the umbrella of dissociative symptoms as they pertain to ASD.

Dissociative amnesia is a mental disorder in which someone reports experiencing memory gaps. What makes this symptom unique, however, is these reported memory gaps are reported retrospectively.

Avoidance Symptoms

We’ve all avoided nastier moments or memories in our lives at one time or another.

In the context of ASD, avoidance symptoms manifest when someone who’s incurred trauma does all they can to avoid the thoughts and feelings of the trauma itself.

The traumatized person will do just about anything to not re-experience their traumatic event and its coinciding pain.

What makes the avoidance symptoms noticeable is the lengths to which one will go to, well, avoid what will trigger their trauma: people, places and the like.

Arousal Symptoms

Arousal symptoms have several components. 

First, a telltale sign of arousal symptoms is when one has trouble with their sleep. What makes the matter more complex is the sleep problems can show in either one’s inability to fall asleep, or one’s inability to stay asleep.

Next is the problem of distractibility. When it comes to distractibility, we mean it’s easier for the person-in-question to lose their focus.

Finally, a person with arousal symptoms is hyper-aware of their surroundings, causing the traumatized person to be more on edge than usual. Resultantly, the person can have unusually strong, reflexive reactions to what’s happening to them, as well as to changes in their surroundings.

Once these symptoms are diagnosed and established by a medical professional, the patient has to display these symptoms for between three days and four weeks — as well as exhibit seriously impaired functionality — to be diagnosed with ASD.

Can You Treat Acute Stress Disorder?

You absolutely can.

There are a variety of approaches that can directly address one’s ASD and get them on the path to living a better, happier and calmer life.


First, psychotherapy is an excellent tool in assisting someone suffering from ASD.

Treatment with psychotherapy often begins with a type of Cognitive Behavioral Therapy, known as trauma-focused CBT.

CBT is a psychological treatment shown to assist many kinds of mental health challenges and mental health disorders.

The purpose of CBT is to help the patient to recognize that some of their problems are focused on faulty, unhelpful ways of thinking.

CBT also focuses on unhelpful patterns of behavior a patient exhibits.

By focusing on unhelpful thought and behavioral patterns, CBT believes it can help the patient learn to cope with these unhelpful thoughts and behaviors by changing them.

When it comes to trauma-focused CBT as it relates to ASD, a therapist will work to understand the patient’s negative emotions in relation to the traumatic event or stressful event they experienced. 

With a greater understanding of these feelings and their connections to each other, trauma-focused CBT believes it can help the patient best control their trauma.

Falling under the umbrella of trauma-focused CBT are three specific kinds of therapy to assist those who are traumatized. Those three therapies are:

  • Prolonged Exposure (PE) aims to reduce the potency of negative feelings caused when one is reminded of a traumatic event. To reduce the negative feelings’ potency, a therapist helps the patient continually confront the negative feelings associated with the traumatic event to wear down the potency of remembering the event itself.

  • Cognitive Processing Theory (CPT) hones in on the detrimental, unhelpful thoughts and narratives the traumatized patient has built around their identity, the trauma they’ve incurred and the experience of the trauma itself.

  • Common Elements Treatment Approach (CETA) zeroes in on the symptoms one carries in relation to their ASD. After the specific symptoms are identified, CETA is then employed to specifically address those ASD-specific symptoms.


Another effective treatment to combat the emotional and psychological distress caused by mental health challenges like ASD is psychiatry.

Psychiatry is a form of talk medicine that is supplemented with medication provided by your psychiatrist.

Psychiatry is appropriate when medication is required to help overcome psychiatric disorders in addition to talk therapy.

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You Can Do Something About ASD

It’s never too late — or too shameful — to admit that you need help.

A mental health challenge like ASD, although it sounds daunting, isn’t a challenge that you should not — or cannot — begin to tackle, contain and overcome. 

Anyone who’s experienced a serious mental health challenge — whether it’s ASD or another form of trauma — knows that finding the right mental health professional to give the right advice is critical in tackling their challenges.

We hope we can help you begin the necessary work of overcoming your own challenges, whatever they may be.

12 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

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  3. Aulagnier M, Verger P, Rouillon F. [Efficiency of psychological debriefing in preventing post-traumatic stress disorders]. Rev Epidemiol Sante Publique. 2004 Feb;52(1):67-79. Available from:
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  5. What is Cognitive Behavioral Therapy? (n.d.). American Psychological Association. Retrieved January 23, 2022, from
  6. Leong, S., Waits, W., & Diebold, C. (2006). Dissociative Amnesia and DSM-IV-TR Cluster C Personality Traits. Psychiatry (Edgmont (Pa. : Township)), 3(1), 51—55.
  7. Kavan, PhD, M. G., Elsasser, PharmD, G. N., & Barone, MD, E. J. (2012, October 1). The Physician’s Role in Managing Acute Stress Disorder. American Family Physician.
  8. Veterans Affairs. (2019, October 17). Acute Stress Disorder.
  9. Şar V. (2014). The many faces of dissociation: opportunities for innovative research in psychiatry. Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology, 12(3), 171—179.
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  11. What Is Psychiatry? (n.d.). American Psychiatric Association. Retrieved February 1, 2022, from
  12. (n.d.). Truama-Focused Cogtive Behavioral Threrapy (TF-CBT). Retrieved January 31, 2022, from

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Mary Lucas, RN
Mary Lucas, RN

Mary is an accomplished emergency and trauma RN with more than 10 years of healthcare experience. 

As a data scientist with a Masters degree in Health Informatics and Data Analytics from Boston University, Mary uses healthcare data to inform individual and public health efforts.

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