Acute & Post Traumatic Stress Disorder

Updated: Apr 25

Acute Traumatic Stress Disorder (ATSD) is when behavioural disturbances develop within the first month after a traumatic event. Or in more technical terms: The disturbance lasts a minimum of 2 days and a maximum of 4 weeks and occurs within 4 weeks of the traumatic event. To diagnose ATSD is very difficult. Shock after an incident that lasts for several hours or a couple of days is technically not classified as ATSD.

The first Criteria is that a person has been exposed to a traumatic event where both of the following has happened:

- A person has experienced or witnessed actual or threatened death, serious injury or breach of physical integrity.

- The person’s response involved intense fear, helplessness or horror.

The person will have 3 or more of the following symptoms:

1. Subjective sense of numbing, detachment, or absence of emotional responsiveness.

2. A reduction in awareness of their surroundings. Being in a daze.

3. Derealisation, where the world doesn’t seem real.

4. Depersonalisation. The person feels detached from their body, as if they are an outside observer.

5. Dissociative amnesia. One doesn’t remember certain aspects of the trauma.

6. The traumatic event is re-experienced in images, thoughts, dreams, or distress on exposure to reminders.

7. There is an avoidance of stimuli which reminders the person of the event. The 5 senses, sight, smell, taste, touch, hear can trigger flashbacks.

8. Increase in anxiety symptoms like difficulty sleeping, irritability, poor concentration, hypervigilance, and exaggerated startle response.

9. The occurrence causes clinically significant distress or impairment in day to day living.

10. Impedes the person in completing certain tasks which are required to be done.

11. The effects are not from taking a substance or a medical condition

As you can see there are many symptoms of ATSD which may be evident. With children it becomes even more difficult to diagnose. They may withdraw completely and or talk about everything else except the event or events.

If the above symptoms persist for longer than a month then this diagnosis is changed to Post Traumatic Stress Disorder (PTSD). These symptoms normally develop within 3 months of a traumatic event but occasionally symptoms do not start until years later. An example of this is when a child is sexually abused but they exhibit no symptoms until they reach puberty. When the young person becomes more sexual this awakens the trauma of the past. These young adults may avoid sexual relationships altogether because it triggers the past trauma. In other cases, the reverse may happen and may bring about sexual perversion or addiction. In adult’s PTSD is responsible for a high rate in relationship problems and break ups. People with PTSD may find it extremely difficult to hold a job for extended periods of time. They may start to organise their lives around avoiding everything that reminds them of the traumatic event. This may then lead to Agoraphobia.

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An alarming statistic out of the USA states that large numbers of Vietnam veterans suffering from PTSD, have committed suicide. This is twice the number of veterans that where actually killed during the Vietnam war.

There are some secondary symptoms of PTSD:

- Depression

- Anxiety

- Predominate negative thoughts

- Substance abuse

- Agoraphobia

- Decreased self-esteem

- Loss in sustained beliefs

- Hopelessness

- Sense of being permanently damaged

- Difficulties in relationships

- Isolation

Techniques used by a health care workers, psychologist, psychiatrist and counsellors for treating ATSD and PTSD may be:

- Non-judgemental empathetic listening – Trauma victims may want to tell their story many times to the same person. It is important to not interrupt but allow them to talk about it.

- Reactions are normal – Telling the person that what they are experiencing is normal for somebody who has experienced a traumatic event or events.

- Exposure Therapy – The client is exposed to the memories of the event to help relieve them, and the associated feelings. This brings about systematic desensitisation. This must be led only by experienced qualified trauma therapists.

- Move the Body – The client to do some exercise and stretching. This will build a fitter stronger body but also release those feel good chemicals into the blood stream.

- Meditate – The client could practice sensations meditation which will make the client more self-aware. Find a good meditation teacher and practice this daily.

- Relaxation techniques – These include slow diaphragmic breathing and moving through the body relaxing each body part. Find a good meditation teacher to learn this.

- Group Therapy – Join a group where the members are all suffering ATSD and or PTSD. It helps to see that others have the same difficulties. It is also good to hear what they have done to tame the beast.

- Medication - Medication might be prescribed depending on the severity of the disorder. This can kick start the recovery. This must be diagnosed and prescribed by Mental Health Nurse, Doctor or Physiatrist.

- Education – Informing the client about the disorder will go along way to help them understand what is going on.

- Cold Therapy – Reducing the core body temperature by at least 1c releases Norepinephrine and dopamine, giving the individual an emotional lift. This should only be done under guidance of a trained cold therapy practitioner. Otherwise hypothermia could result.

If you feel that you may be suffering from the effects of trauma then seek help. There are truly many ways to deal with trauma, ATSD and PTSD.

As a self-test one could use the below checker:

Have you experienced or seen something that involved death, injury, torture or abuse and felt very scared or helpless?

Have you then experienced any of the following:

  • upsetting memories, flashbacks or dreams of the event?

  • feeling physically and psychologically distressed when something reminds you of the event

If you answered yes to all of these questions, have you also experienced at least two of the following:

  • had trouble remembering important parts of the event

  • had very negative beliefs about yourself, others or the world

  • persistently blamed yourself or others for what happened

  • persistently felt negative, angry, guilty or ashamed

  • felt less interested in doing things you used to enjoy

  • feeling cut off from other

  • had trouble feeling positive emotions (e.g. love or excitement)

And have you experienced at least two of the following:

  • had difficulties sleeping (e.g. had bad dreams, or found it hard to fall or stay asleep)

  • felt easily angered or irritated

  • engaged in reckless or self-destructive behaviour

  • had trouble concentrating

  • felt on guard or vigilant

  • been easily startled

If all these things have been happening for a month or more, you may be experiencing post traumatic stress disorder.

If you would like to make an appointment:

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