Acute stress disorder is a result of a traumatic event in which the person experienced or witnessed an event that involved threatened or actual serious injury or death and responded with intense fear and helplessness. The severity of the disorder may be reduced if professional intervention is initiated soon after the trauma. In this post, a case has been provided where a woman named Rima was diagnosed with Acute Stress Disorder, along with the suitable treatment for her designed together by her and her therapist.

CASE HISTORY

Rima went to a theater to see a movie premiere. While she was watching the movie, a man in a mask suddenly appeared in front of the screen. Holding an assault rifle, he fired into the crowd. She saw many people get shot, including the woman sitting next to her. People all around began screaming, and there was a confused stampede for the exit door. Terrified, she somehow fought her way to the exit. She escaped, uninjured, to the parking lot, just as police cars arrived.

Rima had not recovered 4 weeks later. She jumped at the slightest sound and was unable to focus on her work, and had nightmares. She tried to avoid any reminders of the shootings but still remembered the sound of gunfire and the screams. She felt disconnected from her surroundings and from herself.

Untreated cases can develop into Post Traumatic Stress Disorder

Right after a traumatic event, almost everyone is upset. They often feel better within 2–3 days and normal recovery is expected. But, Rima developed acute stress disorder (ASD). Here, symptoms develop after an individual experiences or sees an event involving a threat or actual death, serious injury, or physical violation to the individual or others. ASD is a temporary condition, and symptoms typically persist for at least 3 to 30 days after the traumatic event.

Symptoms fall into the five general categories of intrusion, negative mood, dissociation, avoidance, and arousal, and begin or worsen after the trauma occurred. She had at least 9 very strong symptoms, including nightmares, flashbacks, trouble sleeping, and hypervigilance.

TREATMENT

Rima and her therapist started working together. The main area of treating Acute Stress Disorder is regaining your sense of empowerment. They started with Trauma-focused Cognitive Behavior Therapy which is a form of talking therapy that’s built around the concept that thinking a certain way can fuel or trigger some mental health issues. Rima was guided to understand her thought patterns and to identify any that are unhelpful. She was then able to change the way she thinks. Also, stress-reduction strategies such as mindfulness (like meditation) and relaxation strategies (like breathing exercises) were given to assist with symptoms of anxiety and high arousal, with medication. After a month of counseling and following the prescribed therapies, Rima has started functioning better.

 

Other forms of treatment for ASD can be:

Medications– antidepressants, antianxiety medications, selective serotonin reuptake inhibitors (SSRIs), or anticonvulsants to help treat a person’s symptoms.

Develop effective coping strategies– like, Cognitive processing which is a method to reframe maladaptive appraisals about past trauma and future triggers

Social support– from family and friends

Exposure: in-imagination (reliving) and in vivo exposure to enable extinction learning; contraindicated with extreme avoidance/dissociation, suicidal risk, acute grief.

Untreated cases can develop into Post Traumatic Stress Disorder (PTSD), so early intervention of this condition is critical!

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Puja Roy is a health psychologist and is currently working as a counselor at the Institute of Neurosciences, Kolkata. You can follow her here.