When Mick Jagger, long-time rock-and-roller and front man for The Rolling Stones, was told his girlfriend, L’Wren Scott, committed suicide in March of 2014, his doctor diagnosed him with Acute Stress Disorder (ASD). Jagger’s extreme mental reaction to news of the death caused him to have nightmares and flashbacks. He was advised not to perform for a minimum of 30 days while he dealt with the condition.
Between six and 33 percent of the people who experience a traumatic event develop ASD, according to the U.S. Department of Veteran’s Affairs (https://www.ptsd.va.gov/public/problems/acute-stress-disorder.asp).
What is Acute Stress Disorder
ASD (DSM-5)* is caused by trauma and can occur within the first month following the event. It is a psychological condition that causes a strong emotional response within the individual. People with ASD experience psychological/mental shock, severe anxiety and other symptoms. While many symptoms of ASD overlap with those of Post-Traumatic Stress Disorder (PTSD), one of the differences is that a PTSD diagnosis can’t be given until symptoms have lasted for at least one month.
Traumatic events may vary greatly, and usually the event is or is perceived as life-threatening.
An example of this is people who are in involved in road casualties with severities of all degrees. These people are at direct risk of acute stress, as well as others who were not directly affected, such as witnesses.
The physiological response behind ASD is called the acute stress response. When something fearful or threatening is perceived, people have an automatic response that is to either confront or flee the threat—this is where the term “fight-or-flight response” comes from. The response is almost instantly accompanied by a spike in heart rate, blood pressure, breathing and metabolism, as well as feeling sweaty and muscles tensing up. In fact, when people experience a trauma, they may continue to feel like there are constant threats in their environment due to perceived danger—intrusive memories, dreams—and experience the acute stress response more frequently.
The more directly exposed to a traumatic event a person is, the higher the risk for mental harm. For instance, in a shooting at a school, the child who is hurt will most likely be the most psychologically affected. The child who witnesses a friend being shot or killed has more of a chance to be affected than a student who was in a different part of the building when the event happened. However, even second-hand exposure to violence can cause trauma. Because of this, all parties are watched closely for any signs that they have emotional distress.
*The DSM-5 manual, which is published by the American Psychiatric Association, says that stressful events that don’t include severe and traumatic components don’t lead to ASD.
Who is at Higher Risk for Acute Stress Disorder?
There are several factors that can put people at a higher risk for developing ASD after a trauma. They include:
- Having gone through other traumatic events.
- Having had Post-traumatic Stress Disorder in the past.
- Having had prior mental health problems.
Causes of Acute Stress Disorder
A person can develop ASD from a variety of traumatic events, including:
- Witnessing a death.
- Witnessing a severe accident.
- Exposure to war in the case of either civilians or military.
- Rape or sexual violence.
- A physical attack.
- Kidnapping or being taken as a hostage.
- Terrorist attacks.
- Natural disasters.
Signs and Symptoms of Acute Stress Disorder
People with ASD may suffer from intrusion, which is described as re-experiencing the traumatic event. They will have memories of the event, recurrent dreams and/or flashbacks. These are usually very intense and cause great psychological distress for the person. When a person is in avoidance, he will try to prevent expressing thoughts or feelings that will cause him to remember the event.
Hyperarousal is when the individual expresses himself with reckless or aggressive behavior. He may be self-destructive. People with ASD can have difficulties sleeping and be extra cautious. In addition, the person may be startled easily. They may feel separated from other people, blame the event on themselves or have little pleasure or interest in the things they used to enjoy.
The following are other signs of ASD:
- A decrease in emotional responsiveness.
- Difficulty concentrating.
- Feeling of being disconnected from one’s body.
- Feel like the world is unreal.
- Increasing difficulties remembering details of the traumatic event—dissociative amnesia.
- Sense of numbing, detachment or no emotional responses.*
- A reduced sense of being aware of the surroundings, almost like the person is in a daze.*
- Derealization and depersonalization (not having personal qualities of an individual).*
- Having illusions.
- Feelings of anguish when reminded about the event.
- Difficulty concentrating.
*These symptoms can happen while or after experiencing the traumatic event.
Treatment of Acute Stress Disorder
The most successful treatment for ASD is Cognitive Behavioral Therapy (CBT). Its goal is to change thoughts or patterns of thought that surround the traumatic event. In addition, CBT works to change behaviors in situations that cause anxiety, as well as alleviate symptoms. CBT also works to keep the person with ASD from developing Post-Traumatic Stress Disorder.
Other treatments that seem to work well for individuals with ASD are anxiety management groups and psychological debriefing—or the intense therapeutic intervention immediately following the event so that the individual can “talk about it.” However, in psychological debriefing, some people found that it caused them to be re-traumatized by talking about the event that had caused them pain.
It’s important to get medical treatment within a few hours of experiencing a traumatic event. This will decrease the chance of developing ASD. Individuals who work in jobs that have a high risk for traumatic events, such as those in the military, may find it beneficial to undergo preparation training and counseling. This may lessen their chance of developing ASD or PSTD if such an event should happen. Preparation training might include fake enactments of the traumatic events that could occur. Counseling may be ideal in helping them strengthen their coping mechanisms.