Acute Stress Reaction (Anxiety and Stress)

Acute Stress Reaction (Anxiety and Stress) – Treatment Options

Introduction
Acute stress reaction, also referred to as acute stress disorder (ASD), is a short-term psychological response to a traumatic or highly stressful event such as accidents, natural disasters, violence, or sudden loss. Symptoms typically occur within minutes to days of the event and may include anxiety, intrusive memories, dissociation, irritability, sleep disturbances, and autonomic hyperactivity. While many cases resolve spontaneously, early recognition and intervention are important to prevent progression to post-traumatic stress disorder (PTSD).

1. Immediate Supportive Care

• Psychological first aid:

  • Provide reassurance, safety, and a supportive environment.

  • Normalize stress responses and encourage talking when comfortable.

• Social support: Involving family, friends, or community networks to reduce isolation.

• Practical assistance: Ensuring basic needs (rest, hydration, food, shelter) are met.

2. Psychotherapy and Counseling

• Trauma-focused cognitive-behavioral therapy (CBT):

  • Most effective in preventing chronic PTSD.

  • Focuses on processing the trauma, coping strategies, and restructuring negative thoughts.

• Exposure therapy (graded and controlled):

  • Helps reduce avoidance behaviors and anxiety related to trauma reminders.

• Stress management techniques:

  • Relaxation training, mindfulness, breathing exercises.

3. Pharmacologic Therapy (Symptom-Oriented, Short-Term Use)

• Anxiolytics (short-term):

  • Benzodiazepines (lorazepam, diazepam) for severe acute anxiety, agitation, or insomnia. Use cautiously and for limited duration due to dependence risk.

• Antidepressants (SSRIs, SNRIs):

  • Not typically started in acute stress reaction unless symptoms persist or evolve into PTSD or major depressive disorder.

• Sleep aids:

  • Short-term agents (zolpidem, low-dose trazodone) may be considered for severe insomnia.

4. Lifestyle and Self-Care Strategies

• Adequate sleep and structured daily routine.

• Physical activity to reduce anxiety and improve mood.

• Avoidance of alcohol, stimulants, and recreational drugs.

• Journaling, relaxation practices, or spiritual support if culturally appropriate.

5. Monitoring and Follow-Up

• Reassess after days to weeks for symptom progression or resolution.

• Identify individuals at higher risk of developing PTSD (prolonged distress, severe trauma exposure, lack of support).

• Referral to mental health professionals if symptoms persist beyond 4 weeks or worsen significantly.

6. Multidisciplinary Care

• Primary care providers: Initial recognition, reassurance, and referral.

• Psychiatrists/Psychologists: For psychotherapy and medication management.

• Social workers/community services: To address social and environmental needs.

• Emergency/trauma teams: For victims of accidents or disasters requiring immediate holistic care.