Acute Stress Disorder

Treatment Approaches

1. Psychological First Aid & Stabilization: In the immediate aftermath of trauma, the first steps are about ensuring you feel safe and supported. Mental health professionals often use a model called Psychological First Aid. This isn’t forcing you to relive the trauma; rather, it’s about listening to your needs, providing practical support, and helping you stabilize. In practice, that might mean: talking with you about safe places to stay or people you can call if you’re feeling scared, normalizing some of your initial reactions (“It makes sense you’re feeling jumpy after what you went through”), and teaching very simple grounding techniques. Grounding techniques help pull you out of distressing flashbacks or dissociative moments – for example, a therapist might have you describe your surroundings in detail, focus on the sensations of holding an object, or do slow breathing, so your mind returns to the present. If you’re in teletherapy, the counselor might guide you to create a “comfort corner” at home with a blanket, tea, or a trusted friend on standby while you talk, to help you feel secure. In short, early sessions focus on reducing acute distress: ensuring you’re sleeping enough (maybe using basic relaxation audio or temporarily something like melatonin), eating, and not feeling alone. We also make sure you understand that your symptoms, while frightening, are a common human response – this alone can reduce panic about what you’re experiencing.

2. Trauma-Focused Therapy (Brief): Once you’re a bit stabilized (often within a couple of weeks of the event), therapy can carefully start to help you process the trauma. Given the short window of ASD, treatment might be more condensed or acute. Techniques from Cognitive Behavioral Therapy for trauma (CBT) can be used in a brief format. This can include gradually talking through what happened – at a pace you can handle – to help your brain organize the memories and realize that it’s in the past. You won’t be forced to do this all at once; it might be step by step (for example, first just describing the lead-up to the event, then later the most upsetting moments when you’re ready). We’ll work on identifying trauma-related thoughts like “It was my fault” or “I’m not safe anywhere now”, and then the therapist helps you challenge or reframe these thoughts (maybe considering evidence against that self-blame, or recognizing that the event was rare and specific, not a sign of constant danger). Another component is exposure to reminders in a controlled way: for example, if you’ve been avoiding driving after a car accident, the therapist might soon encourage small steps like sitting in a parked car with them (via teletherapy, maybe you’d keep a video connection as you try starting the engine). This exposure with guidance helps reduce avoidance behaviors and teaches your brain that cues (like getting in a car) don’t always lead to trauma – essentially retraining your fight-or-flight response. Throughout this, coping skills are reinforced: you’ll practice relaxation or grounding each session so that you can handle anxiety spikes during the trauma processing. One specialized brief therapy is Critical Incident Stress Debriefing (CISD), though its use is debated; many clinicians now favor more organic processing rather than a forced single debriefing session. Whichever approach, the aim is to help you process the trauma in a healthy way before memories consolidate into more entrenched PTSD.

3. Medication Management (Short-Term): Medication isn’t always necessary for ASD, but it can be quite helpful for certain acute symptoms. For instance, if you’re having relentless insomnia or nightmares that leave you exhausted, a short course of sleep medication (like a non-benzodiazepine sleep aid) might be prescribed to help you get some rest. Sometimes prazosin, a blood pressure medication, is used off-label to reduce trauma-related nightmares and has shown effectiveness in PTSD – it could be considered in acute stress if nightmares are severe. For intense anxiety or panic attacks, a doctor might prescribe a short-term benzodiazepine or a fast-acting anxiolytic for a week or two, just to give you relief while therapy starts working. However, caution is used with these because we don’t want to mask symptoms without processing them, and some medications (like benzodiazepines) could theoretically complicate the natural recovery process or lead to dependence if used too long. In some cases, an SSRI antidepressant might be initiated early on if the person has a history of anxiety/depression or if the acute stress symptoms are very high and not rapidly resolving – SSRIs can help with anxiety and are standard in PTSD, so starting one might help prevent the progression of symptoms. It won’t act immediately (SSRIs take a few weeks), but it could support longer-term recovery. The choice to use medication is individualized: we’ll consider the severity of your symptoms, your personal and family history (like if you’re prone to depression, early medication could be preventive), and your preferences. Importantly, any medication would be combined with therapy, not used alone. Telehealth makes checking in about meds easier – frequent brief contacts to adjust dose or address side effects in those early weeks can be done by phone or video. The plan would usually be to use meds short-term and taper off as you recover within that first month or two. The goal is to ensure you’re not suffering needlessly – if you’re so anxious you can’t engage in therapy, medication can lower that anxiety enough for you to participate in the healing process.

4. Safety and Follow-Up: Throughout the treatment of ASD, a critical focus is maintaining safety – both physical and emotional. Trauma can leave you feeling unsafe in general, so part of therapy is helping you identify ways to increase your sense of security. This might mean altering your environment temporarily (like staying with a friend or relative if being alone worsens your fear), or developing a crisis plan: knowing who to call or what self-soothing strategies to use if you feel a surge of panic or despair. We also address any risky coping behaviors: if you find yourself drinking a lot or driving recklessly due to agitation, we intervene and find healthier alternatives. As you approach the one-month mark post-trauma, we’ll evaluate together if symptoms have resolved or are on track to resolve. Many people will find significant relief in a few weeks with proper support. If you’re one of those who still have substantial symptoms after a month, we might consider transitioning the diagnosis to PTSD and adjust the treatment plan accordingly (perhaps moving to longer-term trauma-focused therapy). But the early intervention often reduces that risk. We won’t just drop support at 30 days – rather, we’ll continue care as needed, but the emphasis might shift from acute stabilization to deeper trauma work for PTSD if it develops. For those who recover, we often schedule a follow-up or two a bit later (say, after 2 months) to ensure things remain stable and that no new issues have popped up. This follow-up is also a chance to reinforce resilience techniques: we’ll discuss what worked for you in coping with this trauma and how you can apply those skills in the future. Experiencing and overcoming acute stress disorder can be empowering – you survived the event and you got through the aftermath. We help you acknowledge that strength. Lastly, we educate you on potential delayed reactions; sometimes anniversary dates or legal proceedings related to the trauma can retrigger stress. Knowing this, you can be prepared and perhaps schedule a booster session around those times. In essence, we don’t just treat and discharge – we ensure you have a roadmap and resources to maintain your mental health moving forward. Overcoming acute stress is not just about mitigating harm; it can also be a stepping stone to personal growth, showing you that you can cope with extremely difficult situations and heal. Our treatment is geared toward that recovery and growth, so that the traumatic event becomes not a continued source of suffering, but a story of resilience in your life.