Acute Stress Disorder vs. PTSD: The Difference Between the Two

Acute Stress Disorder (ASD) is an anxiety disorder that occurs within days to weeks after a traumatic event, with symptoms appearing within one month. These can include dissociative experiences like numbness and depersonalization, as well as flashbacks and avoidance of triggers. ASD symptoms typically last 3 to 30 days and often resolve without significant intervention.

Post-Traumatic Stress Disorder (PTSD) is a mental health condition that may develop after trauma, with symptoms potentially emerging months later. PTSD can severely disrupt daily functioning, causing anxiety, emotional numbness, and hypervigilance. Individuals often avoid trauma reminders, leading to sleep difficulties and varied impacts based on personal experiences.

The primary distinctions between Acute Stress Disorder and Post-Traumatic Stress Disorder lie in their onset, duration, and symptom severity. ASD symptoms appear shortly after trauma and typically resolve within weeks, while PTSD symptoms may develop later and persist for months or years, often leading to chronic issues. 

ASD can evolve into PTSD if symptoms do not resolve. According to Feely, D.’s 2023 study, “Acute stress symptoms 1-2 weeks after stroke predict the subsequent development of post-traumatic stress symptoms,” 22% of stroke survivors experienced acute stress disorder (ASD) shortly after their stroke, with 62.5% of those later developing post-traumatic stress disorder (PTSD). Two patients developed PTSD without prior ASD symptoms. The study highlights the need for healthcare providers to monitor stroke patients for both ASD and PTSD, as early stress symptoms can indicate future PTSD risk.

PTSD is characterized by more severe and lasting symptoms that significantly impair daily functioning. Treatment approaches also differ, with ASD often requiring short-term interventions, while PTSD may necessitate long-term therapy and support.

What is Acute Stress Disorder?

Acute Stress Disorder or ASD is an anxiety disorder that arises days to weeks after trauma. Symptoms appear within one month and resemble those of post-traumatic stress disorder (PTSD). ASD symptoms last 3 to 30 days and often resolve without major mental health intervention.

To diagnose ASD, at least three dissociative symptoms must be present, such as:

• Numbness
• Reduced awareness
• Depersonalization
• Derealization
• Dissociative amnesia

Reexperiencing trauma can occur through:

• Flashbacks
• Nightmares
• Recurring thoughts
• Illusions

Individuals may avoid trauma triggers (places, people, objects). Other symptoms may include:

• Inability to relax
• Heightened startle response
• Sleep and concentration difficulties
• Significant daily distress

What are the Signs and Symptoms of Acute Stress Disorder?

The signs and symptoms of acute stress disorder include anxiety, distress, avoidance, dissociation, and reexperiencing of trauma. To be diagnosed, individuals must exhibit at least three dissociative symptoms, such as emotional numbness, reduced awareness, depersonalization, derealization, and dissociative amnesia. Furthermore, evidence of reexperiencing symptoms, including flashbacks and nightmares, is required. Common signs also encompass hyperarousal, sleep disturbances, concentration difficulties, and significant distress in daily activities.

The signs and symptoms of acute stress disorder include:

• Anxiety and distress
• Avoidance of trauma triggers
• Dissociative symptoms (minimum of three required):
  • Emotional numbness or unresponsiveness
  • Reduced awareness of surroundings
  • Depersonalization
  • Derealization
  • Dissociative amnesia
• Reexperiencing symptoms:
  • Flashbacks
  • Nightmares
  • Recurring thoughts
  • Illusions
• Hyperarousal symptoms:
  • Inability to sit still or relax
  • Elevated startle reflex
  • Difficulties sleeping
  • Concentration difficulties
• Significant distress in daily activities

What Causes Acute Stress Disorder?

Causes of Acute Stress Disorder include:

• Direct experience of traumatic events
• Witnessing traumatic situations
• Learning about traumatic events happening to others
• Previous history of trauma
• Past diagnoses of acute stress disorder or PTSD
• Pre-existing mental health conditions
• Exposure to situations that can trigger traumatic memories

According to the United States Department of Veterans Affairs, approximately 6-33% of individuals who experience a traumatic event will develop acute stress disorder.

What is Post-Traumatic Stress Disorder

Post-traumatic stress disorder, commonly called PTSD, is a mental health condition that arises after experiencing or witnessing trauma. Trauma varies in form and impacts individuals differently. Examples include childhood loss, abuse, or neglect, as well as adult experiences like violence, terrorism, or natural disasters. Symptoms can also develop from learning about trauma affecting someone close.

Individuals may struggle with daily functioning due to fatigue from disrupted sleep. Common indications of PTSD include:

• Frequent anxiety
• Aggressive or impulsive behavior
• Problems at home, work, or school
• Emotional numbness
• Hyperactivity to stimuli
• Hypervigilance

What are the Signs and Symptoms of Post-Traumatic Stress Disorder?

The signs and symptoms of post-traumatic stress disorder (PTSD) include persistent memories or flashbacks of the trauma, which can feel ever-present despite efforts to ignore them. Individuals often engage in avoidance behaviors to steer clear of triggers that may provoke these memories, leading to difficulties in daily functioning and sleep disturbances due to nightmares. Common symptoms encompass anxiety, aggressive or impulsive behaviors, challenges in various life domains, hyperactivity to stimuli, emotional numbness, and hypervigilance.

The signs and symptoms of post-traumatic stress disorder (PTSD) include:

• Persistent memories or flashbacks of the trauma
• Avoidance of triggers related to the trauma
• Difficulties sleeping due to nightmares
• Fatigue affecting daily functioning
• Frequent anxiety
• Aggressive or impulsive behaviors
• Problems at home, work, or school
• Hyperactivity to everyday stimuli and sounds
• Emotional numbness
• Hypervigilance

What Causes PTSD?

Post-traumatic stress disorder (PTSD) is caused by exposure to traumatic events that overwhelm a person’s ability to cope. These traumatic experiences can occur through direct exposure, witnessing an event, or learning about trauma happening to a close family member or friend.

The impact of trauma varies significantly among individuals, with different people responding differently to similar events. What causes PTSD in one person may not trigger it in another. 

Common causes include:

• Physical or sexual assault
• Combat exposure
• Terrorist attacks
• Natural disasters
• Serious accidents
• Life-threatening illnesses
• Childhood abuse
• Sudden loss of loved ones
• Severe injuries or medical trauma

The development of PTSD depends on various factors, including the intensity and duration of trauma, personal resilience, and available support systems.

What’s the Difference Between ASD and PTSD?

The difference between ASD and PTSD lies in their onset, duration, and symptomatology, even though both are mental health conditions that can occur after experiencing or witnessing a traumatic event.

The following table outlines these critical differences to help clarify the distinctions between the two disorders.

Feature	Acute Stress Disorder (ASD)	Post-Traumatic Stress Disorder (PTSD)
Onset of Symptoms	Symptoms appear within a few days to weeks after the trauma.	Symptoms may take longer to develop, often appearing months after the trauma.
Duration of Symptoms	Symptoms typically resolve within a few weeks.	Symptoms can persist for months or years, often becoming chronic.
Evolution	Can evolve into PTSD if symptoms do not resolve.	PTSD is a long-term condition that may develop from ASD or occur independently.
Common Symptoms	Intrusive memories, avoidance, negative mood, dissociation, hyperarousal.	Similar symptoms as ASD but may include more severe and persistent distress, emotional numbing, and avoidance behaviors.
Impact on Functioning	May cause temporary impairment in daily functioning.	Often leads to significant impairment in social, occupational, and other important areas of functioning.
Treatment Approaches	Short-term interventions, such as counseling or therapy, may be effective.	May require long-term therapy, medication, and support to manage symptoms.

What Are The Treatment for Acute Stress Disorder and PTSD?

The treatments for acute stress disorder and PTSD share many similarities, despite ASD sometimes resolving without significant mental health intervention. While few evidence-based treatment models explicitly target ASD symptoms, those needing help will find that ASD treatments closely mirror those for PTSD. Common therapeutic treatments for PTSD include psychotherapy and medications, with cognitive-behavioral therapy being the most widely used behavioral therapy in PTSD treatment programs.

Cognitive-Behavioral Therapy (CBT)

Cognitive-behavioral therapy (CBT) is a successful, evidence-based psychotherapy model that has consistently shown effectiveness for both PTSD and ASD. Its effectiveness has been established in both short- and long-term treatment settings. CBT is part of a trauma-focused therapy program, meaning that the specific events related to the trauma are the central focus of each treatment session.

CBT sessions aim to help individuals identify, understand, and change unhelpful thinking and behavior patterns. This active form of therapy requires high levels of engagement from the patient, who is expected to practice the skills learned during sessions both inside and outside of appointments.

CBT encompasses various treatment procedures categorized as behavioral restructuring therapies. Different CBT models vary in the intensity of exposure and cognitive interventions required, highlighting the importance of tailoring therapy to meet individual needs. Key components of CBT for PTSD and ASD include:

1. Cognitive Restructuring: This intervention helps individuals process and make sense of painful memories. It is common for those with trauma histories to remember events differently than they occurred, often feeling guilt or shame about aspects beyond their control. Cognitive restructuring encourages an objective examination of the trauma, fostering a more realistic perspective.
2. Exposure Therapy: This method helps individuals manage their fears through intentional exposure to trauma-related memories or triggers. Conducted in a safe and supportive environment by a trained trauma therapist, exposure therapy focuses on gradual exposure to the traumatic event, reducing sensitivity and emotional reactions over time. While effective, exposure therapy can be intense and frightening, necessitating skilled guidance from professionals familiar with PTSD.

Medications

While no medication has been approved by the Food and Drug Administration (FDA) to “cure” PTSD or ASD, anti-anxiety and antidepressant medications may provide symptom relief during the early stages of treatment for some individuals. It is essential to understand that medications should not serve as standalone treatments or substitutes for comprehensive therapy programs. Instead, when used in conjunction with therapy, medications can assist in managing symptoms, allowing individuals to focus on the therapeutic aspects of their treatment.

While there is no way to prevent the type of trauma that causes acute stress disorder or post-traumatic stress disorder, it is possible to learn healthy and effective ways to manage symptoms of both conditions. To learn more about treatments and interventions for acute stress disorder and post-traumatic stress disorder, contact a member of our treatment team at The Los Angeles Outpatient Center today to learn more about our programs.