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An acute stress reaction occurs when symptoms, including anxiety, develop quickly as a reaction to exceptionally stressful events. Symptoms often go quickly, and you may not need any treatment. Sometimes other treatments, such as talking therapies, may be helpful.

What is an acute stress reaction?

An acute stress reaction occurs when symptoms develop due to a particularly stressful event. The word acute means the symptoms develop quickly, but do not usually last long. The events are usually very severe and an acute stress reaction typically occurs after an unexpected life crisis. This might be, for example, a serious accident, sudden bereavement, or other traumatic events. Road traffic accidents cause many casualties each year and you may be directly or indirectly affected by this kind of exceptionally stressful event. Acute stress reactions may also occur as a consequence of sexual assaults or domestic violence.

Acute stress reactions have been seen in people who experience terrorist incidents or major disasters. They may also occur in people who experience war in their countries. Military personnel are at more risk as a result of extreme experiences during conflicts.

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What are the symptoms of an acute stress reaction?

Symptoms usually develop quickly over minutes or hours – reacting to the stressful event. They usually settle fairly quickly, but can sometimes last for several days or weeks. Symptoms of acute stress reactions may include the following:
•Psychological symptoms such as anxiety, low mood, irritability, emotional ups and downs, poor sleep, poor concentration, wanting to be alone.
•Recurrent dreams or flashbacks, which can be intrusive and unpleasant.
•Avoidance of anything that will trigger memories. This may mean avoiding people, conversations, or other situations, as they cause distress and anxiety.
•Reckless or aggressive behaviour that may be self-destructive.
•Feeling emotionally numb and detached from others.
•Physical symptoms such as: •A thumping heart (palpitations)
•Feeling sick (nausea)
•Chest pain
•Headaches
•Tummy (abdominal) pains
•Breathing difficulties

The physical symptoms are caused by stress hormones, such as adrenaline (epinephrine), which are released into the bloodstream, and by overactivity of nervous impulses to various parts of the body.

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What are the treatments for acute stress disorder?

No treatment may be needed, as symptoms usually go once the stressful event is over and you deal with it. Understanding the cause of symptoms, and talking things over with a friend or family member, may help. However, some people have more severe or prolonged symptoms. One or more of the following may then help:

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Spotting stress
Cognitive behavioural therapy (CBT)

Cognitive Behavioural Therapy (CBT) is a talking therapy and is based on the idea that certain ways of thinking can trigger or fuel certain mental health problems. The therapist helps you to understand your current thought patterns. In particular, to identify any harmful, unhelpful and false ideas or thoughts. The aim is then to change your ways of thinking in order to avoid these ideas and help your thought patterns to be more realistic and helpful. When it is used for acute stress reactions it is known as trauma-focused CBT.

Counselling

This may be an option if symptoms are persistent or severe. Counselling helps you to explore ways of dealing with stress and stress symptoms. This may be available locally but some charities also offer online resources and helplines that may be useful.

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Medications

Taking a medicine may be an option:
•A beta-blocker is one medicine that can help relieve some physical symptoms that are caused by the release of stress hormones. Beta-blockers are not addictive, are not tranquillisers, and do not cause drowsiness or affect performance. You can take them as required.
•Diazepam is a benzodiazepine tranquilliser. These are very rarely used and are reserved for exceptional cases for very short periods. It is addictive and will quickly lose its effect when taken for more than a few days.