By Clinical Psychologist at Oqea Cares, Dr Terry Simpson & Research Manager at Oqea Dr Valeska Berg
Summary
Most people are familiar with the concept of stress, however, there are different types of stress responses people can experience. Stress can be an adaptive and even a beneficial response as the body mobilises various systems to meet the high situational demands or threats. However, chronic stress, i.e. the higher levels of stress we feel on a day-to-day basis, can have a negative impact on our wellbeing and functioning over time.
We can also experience a different type of stress, that is, acute stress. This occurs in response to highly stressful events that are sudden, unexpected or feel very threatening to us in some way. These situations can cause reactions that are out of our usual range of coping and can create an acute stress response. In this article, we explore the differences between chronic stress, and acute stress and how symptoms can lead to post-traumatic stress. We will also explore some strategies to help understand and manage an acute stress response.
What is Acute Stress?
Symptoms of acute stress can occur during or immediately following a traumatic event where we experience or are exposed to a life-threatening situation such as a traffic accident, a medical event, natural disasters (bushfires, earthquakes and floods), exposure to acts of war, physical violence, criminal incidents, or near-death experiences. The traumatic event can have a negative impact on your physical, emotional, and psychological wellbeing and can drain your coping resources.
The symptoms of the acute stress response are similar to those of chronic stress, however, acute stress can also include overwhelming responses such as intense anxiety, fear, flashback episodes, nightmares, sleep difficulties, poor concentration, hypervigilance and avoidance of any reminders of the event. In more severe cases, a person may experience dissociation, feelings of detachment and memory lapses.
An acute stress reaction is the body’s way of meeting the demands of the situation and typically lasts from a few days and up to 3-4 weeks after exposure to the event. In most cases, the symptoms will resolve, and people return to their normal levels of coping. However, if these symptoms last longer than one month and cause significant problems in your day-to-day functioning, you may be experiencing symptoms of Post Traumatic Stress Disorder (PTSD). Symptoms of PTSD can also linger for many months or years in more severe cases. It is unclear exactly why some people go on to develop PTSD while others don’t, but some factors include prior trauma, a history of or co-existing mental health issues, personality factors and subsequent life stress after the event has occurred (Ozer, et al., 2003).
Benefits of Understanding the Acute Stress Response
Stress is our body’s natural response to a perceived threat or a high-pressure situation. The stress response can be physical (e.g., illness), emotional (e.g., grief), or psychological (e.g., fear). Stress can be helpful in the short term, boosting energy, improving memory, and motivating us to face challenges. Factors like how we perceive a situation, and our overall physical health can influence our general stress response. Chronic stress, lasting months to years, can have negative effects on mental and physical health. Chronic stress can interact with situational stress to exacerbate symptoms in an acute stress situation (Hammen, et al. 2009).
Symptoms of an acute stress response can occur either during the time of exposure to the traumatic event, or soon after the event. The body’s acute stress response triggers the release of stress hormones (e.g., cortisol and adrenaline) into the bloodstream and may include physical symptoms such as heart palpitations, shortness of breath, headaches, and stomach pain (McEwen & Sapolsky, 2006).
Putting it Into Practice
Recognising the difference between chronic and acute stress can guide how we respond to and manage stress effectively. In addition, understanding and diagnosing Acute Stress Disorder (ASD) can help in providing early treatment and reducing the risk of developing PTSD (Bryant, 2008).
When dealing with stress after a traumatic event, there are several strategies that you can employ to reduce the impact of the stress on you. Here are some approaches you might find helpful:
Physical Approaches:
- Progressive Muscle Relaxation (PMR): This technique involves sequentially tensing and relaxing different muscle groups (e.g., legs, stomach, back). PMR promotes relaxation and reduces physical tension.
- Physical activity such as regular exercise, is another effective strategy as it can reduce stress hormones and stimulate the production of endorphins, which act as natural painkillers and mood elevators.
- Proper nutrition also plays a role in managing stress. Acute stress can impact our cravings and food choices. Maintaining healthy eating habits is important in managing stress.
Psychological Approaches:
- Mindfulness and meditation: Practicing mindfulness helps you stay present in the moment, reducing anxiety and stress. Techniques like meditation, deep breathing, and body scans can enhance mindfulness.
- Guided Imagery: Visualisation exercises can help you create mental images of peaceful and calming scenes, reducing stress, and promoting relaxation.
- Deep Breathing: Focusing on slow, deliberate breaths can activate the body’s relaxation response. Try inhaling deeply for a count of four, holding for two, and exhaling for six.
- Laughter and Humour: Engage in activities that make you laugh. Laughter triggers the release of endorphins (which are natural mood boosters), amongst other hormonal systems for physiological benefits, which are natural mood boosters (Jobin & Cheramadathikudyl, 2011).
- Sleep and Sleep Hygiene: Prioritise getting enough restful sleep. Adequate sleep is essential as it allows the body to recover from stressful events. There are a number of ways to promote sleep hygiene in order to help with your stress management.
Social Approaches:
- Don’t isolate yourself. Talk with trusted friends, family or a therapist if you feel you need to share your thoughts and feelings with someone.
- Maintain a routine. Keeping to a structured routine can help you feel a level of control and normality during an acute stress reaction.
- Don’t make big life changes. Avoid making life decisions immediately after a traumatic event as our decision-making can be impacted by acute stress (Byrne, et al. 2020).
The evidence-based treatment of choice for Acute Stress Disorder (ASD) is trauma-focused Cognitive Behaviour Therapy (CBT), which has been shown to reduce both Acute Stress Disorder and Post-Traumatic Stress Disorder severity (Bryant, 2016, 2018). In addition, early provision of pharmacological interventions has been promising in reducing the risk of developing PTSD (Bryant, 2018).
The symptoms of acute stress can be very distressing. If you or someone you know is experiencing symptoms of acute stress, it’s important to seek professional help. Early intervention can help manage these symptoms and prevent the development of chronic Post-Traumatic Stress Disorder (PTSD).
These are general guidelines and individual experiences may vary; therefore, it is important to seek professional help for accurate identification and treatment of these symptoms.
References:
Bryant, R. A. (2016). Acute stress disorder: What it is and how to treat it. The Guilford Press. https://psycnet.apa.org/record/2016-13853-000
Bryant, R.A. (2018). The Current Evidence for Acute Stress Disorder. Curr Psychiatry Rep 20, 111. https://doi.org/10.1007/s11920-018-0976-x
Bryant, R. A. Mastrodomenico, J., & Felmingham, K. L. (2008). Treatment of acute stress disorder: A randomised trial. Archives of General Psychiatry, 65(6), 659-667. https://doi.org/10.1001/archpsyc.65.6.659
Byrne, K. A., Peters, C., Willis, H. C., Phan, D., Cornwall, A., & Worthy, D. A. (2020). Acute stress enhances tolerance of uncertainty during decision-making. Cognition, 205. https://doi.org./10.1016/cognition.2020.204448.
Hammen, C., Yim, E. Y., Eberhart, N. K., & Brennan, P. A. (2009). Chronic and acute stress and the prediction of major depression in women. https://doi.org/10.1002/da.20571
Jobin, M., & Cheramadathikudyl, S. P (2011). The healing power of well-being. Acta Neuropsychiatrica, 23 (4), 145-155. https://doi.org/10.1111/j.1601-5215.2011.00578.x
Mc Ewen, B., & Sapolsky, R (2006). Stress and Your Health. The Journal of Clinical Endocrinology & Metabolism, 91(2), E2. https://doi.org/10.1210/jcem.91.2.9994
Ozer, E.J., Best, S.R., Lipsey, T.L., Weiss, D.S. (2003). Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychological Bulletin, Jan; 129(1): 52-73. https://doi.org/10.1037/0033-2909.129.1.52
