All people have to cope with tragic strokes of fate in the course of their lives. But if the experiences are so drastic for the person concerned that they can no longer be mastered with the body's own mechanisms, then it comes to one acute stress reaction.
What is an acute stress reaction?
Experienced traumas can push the human psyche to its limits and overwhelm it. Then a crisis situation occurs - the acute stress reaction.An acute stress reaction is first and foremost a normal response of the human psyche to a stressful experience in life. For this reason, it is not a disease.
Rather, it is an expression of extraordinary emotional stress, for which those affected cannot find an adequate coping strategy. The body's own coping mechanism fails because the stress is too extreme. As a result, a multitude of symptoms occur, which are expressed on both a psychological and a physical level.
causes
The acute stress reaction can be observed especially when a person has personally experienced violence. Regardless of whether experiences of war, physical or psychological violence play a role. All these traumas experienced can bring the human psyche to its limits, overwhelm it. Then a crisis situation occurs - the acute stress reaction.
In addition to the death of a loved one, experiencing serious accidents can also trigger such a reaction. Of course, the reaction to a difficult event also depends on the psyche of the person concerned. An acute stress reaction can occur even if the experience from the outside is perhaps not perceived as serious.
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Immediately during and after the stressful event, the person concerned is stunned. She has the feeling of not being herself, perceiving herself as though through a filter.This phenomenon is called depersonalization. This goes hand in hand with those affected behaving strangely and performing seemingly senseless actions.
The psychological impairments in this phase include impaired perception, disorientation and narrowing of consciousness. The person is in shock. There are also strong mood swings. If the person is full of grief in one moment, they can lash out with rage the next and sink into apathy a little later.
The psychological tension then also hits the body. Sweating, palpitations and nausea can be associated with an acute stress reaction. Furthermore, the person can be tormented by violent nightmares and recurring memories of what they have experienced. Sleep disorders, decreased sensitivity and increased irritability are also characteristic of this crisis situation.
Diagnosis & course
In the acute phase, i.e. the time during and shortly after the occurrence of the stressful event, the person concerned is like a different person. His personality changes, he behaves strangely and deviating from his normal behavior. Other people find it difficult to get hold of him, also because of the extremely pronounced emotional mood swings.
The acute reaction to a bad event can last for hours to days, in extreme cases even weeks. In the acute phase, other symptoms occur than in the subsequent processing phase. In the processing phase, memories of the bad event keep coming back. Sleep can be disturbed and nightmares are common. What has happened is processed day and night.
During this time, the person concerned is more irritable and more frightened than usual. In the processing phase, the complaints decrease in intensity and sooner or later disappear completely. However, if the typical symptoms last longer than four weeks and affect the person's everyday life, the acute stress reaction has become a post-traumatic stress disorder. This should definitely be treated psychotherapeutically because, unlike the stress reaction, it is a disease.
Complications
The acute stress reaction can also have psychological consequences over the acute period. As it progresses, it may develop into a post-traumatic stress disorder or an adjustment disorder. However, other mental illnesses are also conceivable as a result of the mental shock: The heavy burden can serve as a trigger for disorders for which a predisposition is already present.
Such critical life events may also trigger a relapse into previous mental illnesses or destructive thought and behavior patterns. In addition, some people who suffer from psychological shock pose a temporary danger to others or to themselves. In some cases, targeted self-harm, such as cutting, burning, pulling hair or blunt blows, occurs. Suicidality can also occur.
Aggression is another possible complication of the acute stress response. The person can temporarily appear completely alienated and no longer be themselves in character. If the acute stress disorder is treated incorrectly, complications are also possible.
A too early confrontation with the traumatic event may have a re-traumatizing effect: Instead of working through the trauma, it is mentally relived and solidified. Violent and insensitive reactions to aggressive or self-damaging behavior can also represent an additional burden for the person concerned or even have a traumatic effect themselves. For this reason, a cautious approach is required.
When should you go to the doctor?
If the person concerned poses an imminent danger to himself or to other people, professional help is required. Persistent or strong thoughts of suicide, self-harm, or physical violence towards others are examples of such situations. The first contact can be made through the family doctor. Anyone who is already being treated by a psychiatrist or psychotherapist for other reasons can also contact them directly. In Germany, no referral is required for an appointment with a psychiatrist or psychotherapist.
Many crisis situations come to a head in the late evening or at night. In most of the larger cities there are therefore crisis intervention services that can be contacted in the event of a mental emergency. Especially with very strong, pressing thoughts of suicide, those affected can also turn to the emergency room of a hospital if there is no specialist clinic on site for acute cases in which admission is also possible at night.
It is not always necessary to consult a doctor or psychotherapist in the event of an acute stress reaction. For example, a visit to the doctor is usually not necessary if the heavy exposure lasts for less than two weeks and there are no other urgent reasons (e.g. suicidality).
A low-threshold counseling service is offered by telephone counseling, which can be reached free of charge in Germany on the nationwide telephone number 0800 111 0 111 around the clock.
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Treatment & Therapy
In the case of an acute stress reaction, no help needs to be sought at first. At first it is completely normal for the person affected to develop severe symptoms. However, these should disappear on their own after a few weeks during the processing phase. However, if this does not happen or if the person is in such a desperate state, then professional help should be sought.
Psychotherapeutic treatment by an experienced therapist is indicated here. Three phases can be distinguished in the course of therapy: the stabilization phase, the confrontation with the event and the integration phase. The first part tries to calm the affected person emotionally and to give him a new perspective. The goal is to get him out of the desperate state.
The trauma confrontation is about making the affected person aware of what happened in detail. By reporting the event, he can process the trauma in great detail. In the third part, the integration phase, the person affected is helped to resume normal life. Relatives can also be included in the therapy.
If the person concerned has major problems coping with everyday life, the use of antidepressants and sedatives has proven effective. In the event of a traumatic experience, the person can be helped with two measures. On the one hand with the psychological first aid, with which the person is supported by a competent contact person while the action is taking place.
On the other hand, with the delayed psychological early intervention, which aims to relieve symptoms and prevent post-traumatic stress disorder.
Outlook & forecast
It is not always possible to react correctly to an acute stressful situation. Traumatic experiences often only make themselves felt later through an acute stress disorder or a post-traumatic stress syndrome. In this case, the prognosis is only good if the person concerned turns to a specialist with confidence. If he increasingly withdraws because of his problems, the acute stressful situation can turn into a dangerous situation. It can lead to depression and suicide.
Even an acute stressful situation can feel dramatic. Ignored, it can lead to burnout or a nervous breakdown. It is therefore all the more important to react immediately to acute stress. Talking about it and seeking help can often defuse the situation. If stressful situations last a few days, the outlook is worse. The acute situation has turned into a disorder. The extent to which this requires treatment varies.
Symptoms of stress disorder can often be alleviated through conversation. If those affected do not want to burden their families with this, a psychological day clinic is the right place. The long waiting times for psychological treatment often make the situation worse. The family doctor is best able to decide when medical intervention is necessary and when medical help might be sufficient.
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Since the acute stress reaction is not a disease, but a response of the psyche to a traumatic experience, there are no preventive measures that could be taken in advance.
Aftercare
Follow-up care usually only takes place if a serious experience has occurred and the person concerned cannot foreseeably not be able to process all the circumstances. In this case, a post-traumatic stress disorder threatens to develop. Complaints keep coming back.
The actual therapy is the responsibility of a psychologist or psychotherapist. These sometimes prescribe supplementary medication that supports the self-healing powers. The aim of treatment is to avoid complications. In a pronounced form, an acute stress disorder can lead to suicide.
In such a case, inpatient accommodation is necessary. The immediate environment often plays a part in how quickly a recovery succeeds. Follow-up care is not only aimed at making everyday life easier and eliminating complications. Rather, it is also about preventing a recurrence. Depending on the severity of the disease, the treating family doctor will make an appointment for a new assessment.
However, this is the exception after a final recovery. Instead, the patient is discharged as cured. If an acute stress disorder occurs due to a different occurrence, he must start therapy again. Those affected cannot prevent a recurrence. The body's own coping mechanism can fail at any time.
You can do that yourself
The acute stress reaction is a temporary mental illness that can lead to restrictions in social, professional and family life. Depending on how severe the acute stress reaction is, the person concerned may be unable to work. In this case, it is possible, for example, to leave your doctor on sick leave.
Those affected who do not live alone can inform roommates or family members about the acute stress reaction. This way, they can ask for support or consideration, for example. If possible, those affected should clearly communicate whether and how family and friends can help them. Everyday life with an acute stress reaction is often characterized by a high level of stress. Resources can help reduce this stress. This includes social resources (such as family, friends, etc.) as well as practical opportunities for distraction, sports and things that are good for the general person.
Although an acute stress reaction is a temporary condition, the disease can persist as a post-traumatic stress disorder or promote other mental illnesses. For this reason, it makes sense to closely monitor the acute stress reaction and seek professional help in good time. Few of those affected find a place with a resident psychotherapist in a timely manner. In the case of severe symptoms or suicidality, it is therefore advisable to consider inpatient treatment or to consult your family doctor first.