By David Joel Miller.
Stress can knock you down and leave you in the mud.
Most people have heard of the granddaddy of all the Trauma- and Stressor-Related Disorders, Posttraumatic Stress Disorder, far fewer people have heard of the smaller member of this family, Acute Stress Disorder.
Acute Stress Disorder is a condition in which something bad happens and it knocks you for a loop but eventually it goes away. We do not want to make the normal problems of living into a mental disorder so we only begin counting things as possible disorders when the stressor is still affecting your life at least 3 days after the incident.
A great many people experience some stressor which does not end up becoming PTSD. If you are still having symptoms a month after the event we start thinking this may become long-term and then you get the designation of Posttraumatic Stress Disorder.
We want to keep normal life events out of this equation, so expected events like having an elderly person in your family die an expected death do not count as a trauma disorder, either Acute Stress Disorder or Posttraumatic Stress Disorder.
The full text of the DSM-5 includes a detailed description of how to recognize Acute Stress Disorder but here is a short description of the condition.
Four conditions need to be met for this trauma to be Acute Stress Disorder.
- You get exposed to something that could kill or seriously injure you or someone close to you.
- It happens in the real world. Movies, TV or your imagination do not count.
- This is unexpected.
- You can’t escape the results of this experience. You re-experience the events in more ways than one. Think of people who investigate child abuse or first responders at shootings or those who recover body parts in the war zone in addition to those who were the direct victim.
This experiencing and re-experiencing causes you problems.
The DSM-5 lists 14 symptoms. I will not repeat them all here. For the full text see the DSM-5. These 14 symptoms are clustered in 5 categories. To get the Acute Stress Disorder you need to have at least 9 of the 14 symptoms but they can be from any category.
1.The experience keeps coming back.
You may have nightmares, intrusive thoughts, flashbacks, spacing out and this may be triggered by either internal thoughts or external triggers.
2. This experience bums you out.
Basically you get into and stay in a really negative mood.
3.The trauma spaces you out.
You may get over whelmed and just “bounce” mentally. In more clinical language we would call this dissociation.
4.The result of the experience is it keeps you away from things.
You may find yourself avoiding people, places or things that remind you of the trauma. Some people do not like to be alone or they may use drugs and alcohol to knock themselves out rather than just falling asleep.
5.You are on edge and stay that way.
This could come out as poor sleep, being irritable or angry all the time, loosing your ability to concentrate, or being easily triggered by any little thing. People in this condition are always on high alert for something that might go wrong. The door slams down the block and those with Acute Stress Disorder will jump at a sound others will not notice.
As with the other things we are calling a mental illness this needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities, or cause you personal distress. Otherwise you may have the issues but you will not get the diagnoses if this is a preference not a problem. If the only time this happens is when you are under the influence of drugs or medicines or because of some other physical or medical problem this problem needs to be more than your situation would warrant. These other issues need treating first, then if you still have symptoms you could get this diagnosis.
FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.
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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books