Acute Stress Disorder and Post Traumatic Stress Disorder (PTSD) are two mental health conditions that share similar symptoms and are classified as trauma-and stressor-related disorders. The key differences are timing, symptom duration, and diagnostic criteria.
Acute Stress Disorder often emerges within a few days after experiencing or witnessing trauma, and symptoms last up to one month. PTSD symptoms can develop immediately after, or even months later, and often include a broader range of long-term symptoms that can affect identity, self-esteem, and relationships.
Traumatic Experiences That Cause ASD and PTSD
The causes of ASD and PTSD are often the same and include any experience that puts the nervous system into “fight or flight” mode. Traumatic events that can lead to these disorders include:
- Shoot shootings
- Physical or emotional abuse
- Sexual assault, rape, military sexual trauma
- Car accidents
- Natural disasters
- Serving in war/combat
- Being attacked by a dog or animal
- Serious medical injuries (e.g., burns)
- Witnessing domestic violence
What is Acute Stress Disorder?
Acute stress Disorder describes the presentation of symptoms such as increased anxiety, hypervigilance, and flashbacks that appear 3 days to 1 month following a traumatic event such as assault or abuse [1].
ASD is thought to affect around 19% of people exposed to trauma, with some trauma types having higher rates of ASD than others. These include [1]:
- 13% to 21% experience ASD after car accidents
- 14% after a serious brain injury
- 24% following a physical assault
- 59% following rape
Acute Stress Disorder (ASD) was introduced to the DSM-5 in 1994, and in 2013, it was reclassified as a trauma- and stress-related disorder. According to the DSM-5, symptoms must appear from 3 days to one month following a traumatic event.
If symptoms persist beyond a month, the clinician will assess for PTSD, and ASD would no longer apply. ASD requires 9 of the 14 symptoms related to intrusion, arousal, mood disturbance, avoidance, and dissociation.
Effective Treatment for Acute Stress Disorder
Currently, trauma-focused CBT (TF-CBT) is recommended as a first-line treatment for ASD.
EMDR and Accelerated Resolution Therapy (ART) have also been shown to reduce acute stress symptoms.
ART has been particularly researched in its use among military populations. ART-based interventions have been found to effectively reduce acute stress symptoms in 1 to 5 sessions, providing symptom relief without having to verbalize or relive the trauma [7].
Psychological first aid (PFA) models have also been encouraged during the early aftermath of disasters and violent events. [1].
Examples of psychological first aid include [2]:
- Providing helpful and accurate information about stress responses after trauma, normalizing feelings to reduce confusion, distress, or fear.
- Listening without judgement, offering calm, trauma-informed, compassionate presence to restore their sense of safety and control.
- Helping them with practical needs such as food, water, shelter, transportation, or connecting them with professional support services.
- Connecting survivors with social supports such as family, group therapy, and community resources.
Although not considered an evidence-based treatment, studies show that both providers and survivors are receptive to PFA. For example, recipients of PFA in one study reported increased ability to remain calm, greater emotional control, and improved social functioning [3].
What is PTSD?
Post-traumatic stress Disorder (PTSD) is a mental health condition that develops after experiencing or seeing a life-threatening event. It’s normal to have stress reactions to trauma, but if symptoms last longer than a month and impact functioning, this could be a sign of PTSD.
Nearly 6% of US adults will experience PTSD at some point in their lives, with some of the highest rates among veterans and emergency service personnel (e.g., policemen, firefighters) [4].
According to the DSM-5, to be diagnosed with PTSD, you must have symptoms that fall under the four types of PTSD symptoms. These include [5]:
- Re-experiencing: Nightmares, flashbacks, sensory triggers that trigger stress responses, such as hearing fireworks or watching the news.
- Avoidance: Avoiding situations or people that remind them of the trauma, such as crowds or driving. They may turn to drugs or alcohol, behavioral addictions, or become workaholics to avoid thinking about the traumatic event.
- Negative Mood and Emotional Regulation: Emotional numbness, guilt, shame, intense fear or hypervigilance, and memory loss about the trauma.
- Hyperarousal: Feeling on edge, trouble sleeping, difficulty concentrating, easily started, lack of impulse control can lead to risky behaviors such as substance abuse, reckless driving, or unprotected sex.
Effective Treatment for PTSD
There is a wide range of therapy approaches for treating trauma and PTSD. Unlike Acute Stress Disorder, PTSD often requires long-term, integrative care, often combining more than one treatment modality.
Top-down therapies are used to focus on cognitive distortions and thoughts that drive symptoms. These include:
- Prolonged Exposure Therapy (PE) helps confront trauma memories and gradually reduce fear and avoidance through exposure.
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) combines cognive restructuring with gradual exposure and coping skills training to help process trauma and reduce emotional distress.
- Dialectical Behavioral Therapy (DBT) focuses on skill sets such as emotional regulation, mindfulness, distress tolerance, and relationship building. This can help individuals learn to regulate their emotions and respond appropriately to triggers.
EMDR, ART, and Integrated Therapies
More recently, bottom-up approaches focusing on the connection between mind and body are being used with PTSD. These include:
Eye Movement Desensitization and Reprocessing Therapy (EMDR): Helps process traumatic memories by using bilateral stimulation (eye movements, taps, vibrations) while verbally recalling distressing memories. This has been shown to reduce emotional intensity, aiding healing from prolonged trauma. EMDR is the number one recommended treatment for trauma by the APA and the National Center for PTSD [6].
Accelerated Resolution Therapy: This is similar to EMDR, using rapid eye movements and guided imagery to help patients process and integrate traumatic memories. Unlike EMDR, it does not require verbal recall of trauma, which can be particularly beneficial for those who experience violent or extreme traumatic events such as sexual assault. A 2024 PLOS Mental Health review reported statistically significant reductions in PTSD symptoms across five studies, with additional improvements in sleep, mood, and anxiety [7].
Expressive Therapies: Art, music, and dance therapies use creative processes to help patients access and process trauma nonverbally. This can unlock suppressed emotions and foster self-expression, helping survivors reclaim autonomy and rebuild a sense of identity.
PTSD vs Acute Stress Disorder: Key Differences
| PTSD vs Acute Stress | PTSD | Acute Stress Disorder |
| Onset | Can develop immediately after, or weeks, months, or years later | Develops within 3 days to 1 month after the trauma |
| Duration | Lasts for more than 1 month, often becomes chronic | Lasts between 3 days and 1 month |
| Key Symptoms | Flashbacks, nightmares, strained relationships, negative mood, avoidance, self-esteem, or identity issues | Intrusive memories, hyperarousal, dissociation, and inability to sleep |
| Treatments | Long-term trauma therapies such as EMDR and Prolonged Exposure, integrated body work for somatic processing | Short-term support, trauma-focused CBT, psychological first aid |
Can Acute Stress Disorder Lead to PTSD?
Acute Stress Disorder is a risk factor for developing PTSD. However, not all individuals who meet the criteria for ASD will go on to develop it. And many individuals who are diagnosed with PTSD did not first have an ASD diagnosis. After experiencing a trauma, some people do not show symptoms for weeks, months, or even years. This is an example of when PTSD can develop without an ASD diagnosis.
The majority of people (over 80%) diagnosed with acute stress disorder who do not receive prompt intervention go on to develop PTSD. With early intervention, particularly trauma-focused CBT, that number is often reduced to less than half [1].
Transform Trauma Into Strength and Find Stress Relief at Maple Mountain
At Maple Mountain Mental Health and Wellness, we are committed to following the principles of trauma-informed care to address the physical, mental, and spiritual needs of our clients. Healing doesn’t just mean symptom management; it involves mental processing and somatic integration.
Through a blend of evidence-based therapies, including EMDR, Accelerated Resolution Therapy, and Somatic Experience, combined with integrated wellness activities such as ceramics, painting, car bashing, and rage rooms, we work with you to address the impacts of unprocessed trauma and achieve lasting emotional growth and well-being.
Contact our admissions team today to begin your healing journey.
Sources
[1] National Center for PTSD. 2018. Acute Stress Disorder.
[2] The National Child Traumatic Stress Network. Psychological First Aid (PFA) and Skills for Psychological Recovery (SPR).
[3] Leamy, M. et al. (2024). The Effectiveness and Implementation of Psychological First Aid as a Therapeutic Intervention After Trauma: An Integrative Review. Trauma, violence & abuse, 25(4), 2638–2656.
[4] National Institute of Mental Health. Post-Traumatic Stress Disorder (PTSD).
[5] National Center for PTSD. How Common Is PTSD in Adults?
[6] APA. Eye Movement Desensitization and Reprocessing (EMDR) Therapy.
[7] Storey, D. et al. 2024. Accelerated Resolution Therapy (ART) for the treatment of posttraumatic stress disorder in adults: A systematic review. PLOS Mental Health.