Acute Stress Disorder vs. PTSD: How They Differ, and Why It Matters

When symptoms of serious psychological distress occur shortly after a traumatic experience—within the first month after—and those symptoms last for three days or more, this condition is called acute stress disorder (ASD). While it is very natural to experience distress and have difficulty processing our experiences of trauma, when this lasts for more than a couple of days, it may call for some caring support to help a person move through and past their pain and stress.

Symptoms of ASD may include flashbacks, nightmares, a low mood, negative thoughts, detachment from reality (derealization), distancing from oneself and one’s experiences (depersonalization), avoidance of anything that might be associated with the trauma, numbing of emotions, feeling on edge and irritable, and possibly even feeling guilty about what happened during the trauma or about the fact that they are experiencing such distress and can’t get over it. A person doesn’t need to exhibit all of these symptoms in order to be diagnosed with ASD, and everyone’s experience and symptoms will be unique. When acute stress symptoms continue, they can significantly impair an individual’s ability to function at work, in relationships, socially, and even with their everyday self-care and regular tasks at home. Similar to a fresh wound that should not be ignored because of the danger that it can quickly escalate and even introduce additional illnesses, acute stress disorder should be immediately treated for the best outcomes as a person has the opportunity to successfully process their traumatic experiences. ASD won’t necessarily progress to post-traumatic stress disorder, but it certainly can without early intervention and treatment.

Post-traumatic stress disorder (PTSD) is characterized by later-stage symptoms of distress and difficulty in coping with the aftermath of trauma. It is only after symptoms have been present for more than a month that a diagnosis of PTSD can be determined. But, unlike cases of acute stress disorder, symptoms of PTSD may develop months or even years after the original traumatic event takes place. PTSD may follow on the heels of ASD, but it may also develop later on even if ASD never occurred initially.

The symptoms of PTSD echo those of ASD for the most part and are broken up into four categories:

• Intrusive symptoms, which refer to any memories, dreams, or flashbacks that arise and elicit a strong reaction.
• Negative mood, which can include thoughts, feelings, and a general sense of heaviness—often seeming as if the person is blocked from feelings such as happiness and love. They may also lose interest in the activities and things they previously favored.
• Avoidance symptoms are common as the person doesn’t want to face the intensity of their distress, so they avoid the people and places and even the thoughts and feelings that bring traumatic memories to the surface.
• Hyperarousal symptoms, including sleeplessness, hypervigilance, irritability, angry outbursts, difficulty concentrating, and generally feeling on edge.

Post-traumatic stress disorder can persist for a long time if not treated, and it can severely disrupt the life a person wants and has created for themselves.

Acute stress disorder and PTSD are not fundamentally different. They are both responses to a traumatic experience, and they very closely share a symptomology. However, the duration of the disorders and the timing of their onset do set them apart. These elements of time have a bearing on a person’s diagnosis, but adequate treatment is critically important across the board for these trauma disorders.

Whereas an acute stress disorder diagnosis can carry with it symptoms of dissociation, a PTSD diagnosis involves a dissociative subtype when these symptoms are present. Dissociative symptoms involve disconnection from the surrounding world or from oneself. This can feel for them as if time is slowing down, as if they are out of their body, as if they are watching life through a movie screen or in a daze. Their memory may also be impaired, often forgetting details of the traumatic event itself. Because PTSD, by definition, lasts for longer than ASD, there is value in identifying those individuals experiencing dissociation who may need enhanced psychological care during their recovery journeys.

The nature of the connection between ASD and PTSD does not mean that all cases of acute stress disorder will eventually turn into post-traumatic stress disorder. Nor does it mean that all cases of PTSD necessarily follow ASD. But it is common for the two disorders to occur in sequence following an incidence of trauma.

It is very possible that early attention and treatment for someone with ASD could help to prevent the eventual onset of PTSD. When someone receives professional treatment, they can develop coping strategies before their disorder takes on a chronic hold. In other words, it is a mistake to dismiss acute stress disorder as normal distress that will simply work itself out over time because the very presence of the disorder indicates that the individual is struggling to process their traumatic distress on their own.

Neglect of either of these dangerous disorders can mean a serious increase in the person’s distress, expansion of their symptoms, and potentially the development of co-occurring mental health disorders, such as depression or substance abuse, as a result. The sooner a person receives treatment, the closer they are to the source of the trauma. The later a person receives treatment, the more they will have to wade through time and pain to heal their traumatic experiences and the deeper the symptomology. The vulnerable and fragile nature of these disorders calls for professional treatment from compassionate experts in complex symptoms and traumatic disorders.

At Bridges to Recovery, our knowledgeable clinicians and psychotherapists can determine a client’s complete and accurate diagnosis, as well as the holistic treatment plan for their optimal recovery path. The sooner they can connect with that path, the sooner their best life begins again.