In moments of intense stress and danger, our bodies have a remarkable ability to activate an innate survival mechanisms. They prepare us to confront or flee from threats and mobilizing our resources to ensure our immediate safety. After such high pressure situations however the body is still in a state of psychological shock.

This article explores the symptoms of the acute stress response and its expressions. Moreover, this phase plays the crucial role during early intervention: It opens a unique window to prevent PTSD and lays the foundation for post-traumatic growth.

Background and Symptoms

The Acute Stress Reaction, as defined by the International Classification of Diseases (ICD-10, code F43.0), develops in response to overwhelming stressful events. This can be it physical or psychological stress such as being affected by observing a traumatic event.

The acute stress reaction is an immediate and transient response. Symptoms usually appear directly after the schock event (within minutes) and subside within hours or days after the event. Initially it characterised by disorientation, confusion and narrowing of attention, inability to comprehend stimuli. The person may have have difficulty recalling details of the traumatic event. The sympathetic nervous system responds intensely to the high stress event, leading to an increased release of stress hormones such as adrenaline and cortisol. This results in heightened physiological arousal, rapid heart rate, excessive sweating, and the skin becoming red or flushed in appearance.

Subsequently the person may be withdrawing from the surrounding situation – sometimes to the point of experiencing a disconnected immobility, or becoming agitated and overly active representing unused high physical and emotional energies from the traumatic event.

Preventing PTSD – Dealing with an Acute Stress Reaction

During this phase, it is important to stabilise the person and help it to ground into the present moment after the event. As a first responder, one needs to make gradually contact give a helping hand and help the person to calm down.

For the prevention of post traumatic stress disorder this phase is crucial. Focus on the fact that the person is (relatively) safe now and that the person is not alone (“I am here to help!”). Focus of the conversation should be that the person has survived and what helped surviving. What were the resources the person used during the actual event? What automatic or instinctive choices has the person made? It will be good to anchor them into consciousness.

There is a window of opportunity immediately after the shock event to bring to consciousness resources that helped the person survive.