Acute Stress Disorder (ASD) is a mental health condition that can develop within the first month after a person witnesses, experiences, or is confronted with a traumatic event. Traumatic events may include serious accidents, physical or sexual assault, natural disasters, combat exposure, or the sudden death of a loved one. The condition shares many features with Post-Traumatic Stress Disorder (PTSD), but it is defined by its early onset and shorter duration.

The DSM-5 identifies several symptom clusters associated with ASD:

• Intrusion symptoms: Unwanted, recurring memories of the event; distressing dreams related to the trauma; flashbacks in which the person feels as though the event is reoccurring; and intense psychological or physical distress when exposed to reminders of the trauma.
• Dissociative symptoms: An altered sense of reality, such as feeling that the world is unreal (derealization) or feeling detached from oneself (depersonalization). Some individuals are unable to recall key aspects of the traumatic event (dissociative amnesia).
• Avoidance symptoms: Persistent efforts to avoid distressing memories, thoughts, or feelings related to the event, as well as avoidance of external reminders such as people, places, conversations, or situations associated with the trauma.
• Arousal symptoms: Sleep disturbance, irritability or anger outbursts, difficulty concentrating, hypervigilance (being excessively alert to potential threats), and an exaggerated startle response.
• Negative mood: A persistent inability to experience positive emotions such as happiness, satisfaction, or loving feelings.

To meet diagnostic criteria, a person must exhibit at least nine symptoms from the categories above, the symptoms must cause significant distress or functional impairment, and they must occur between three days and one month after the traumatic event.

Acute Stress Disorder is diagnosed by a qualified mental health professional using a structured clinical interview. The clinician will assess the nature of the traumatic event, the types and severity of symptoms, their duration, and the degree to which symptoms are affecting the person's ability to function. Validated assessment tools such as the Acute Stress Disorder Interview (ASDI) and the Acute Stress Disorder Scale (ASDS) may also be used to support the evaluation.

The primary goal of treatment is to reduce symptom severity, restore daily functioning, and prevent the development of PTSD. The most well-supported treatment approach is trauma-focused Cognitive Behavioral Therapy (CBT). This typically includes psychoeducation about normal stress responses, gradual and controlled exposure to trauma-related memories and situations, cognitive restructuring to address unhelpful beliefs about the event or oneself, and training in anxiety management skills such as controlled breathing and progressive muscle relaxation.

Brief early interventions, sometimes called psychological first aid, focus on meeting immediate safety needs, reducing physiological arousal, promoting social support, and providing practical coping information. Not all people who experience a traumatic event will develop ASD, and many recover naturally with time and social support. However, those whose symptoms are severe, persistent, or worsening should seek professional help promptly.

Research indicates that individuals who receive appropriate early treatment for ASD are significantly less likely to go on to develop PTSD. Treatment is usually short-term, often involving five to eight sessions, and outcomes are generally favorable when intervention begins soon after the traumatic event.

You should consider seeking professional help if your symptoms are severe enough to interfere with your ability to work, care for yourself, or maintain relationships. Difficulty sleeping for more than a few nights, persistent flashbacks, emotional numbness, or the strong urge to avoid all reminders of the event are all signals that professional support could be beneficial.

It is especially important to seek help if your symptoms have lasted more than three days and are not improving, or if they are getting worse over time. If you find yourself using alcohol or other substances to cope, or if you are withdrawing from friends and family, these are additional reasons to reach out to a mental health professional.

If you or someone you know is in immediate danger or experiencing thoughts of self-harm, contact emergency services or call the 988 Suicide and Crisis Lifeline (call or text 988 in the United States). The following resources provide reliable information about Acute Stress Disorder and trauma-related conditions:

• American Psychological Association: Trauma
• National Institute of Mental Health: Coping with Traumatic Events
• NHS: Post-Traumatic Stress Disorder