Acute Stress Reaction
The neuropsychological sciences distinguish several different ways of experiencing, reacting to, and mentally processing situations that are life-threatening or terrifying (or perceived by the victim as such). In the general medical and psychiatric classifications of illnesses, such conditions, if they have obviously pathological character, i.e. impair the well-being, physiological and social functioning of the person, are referred to a class of “neurotic, stress and somatoform disorders”. As it is a question of serious psychological traumas which can roughly and irreversibly break the mechanisms of adaptation, the theoretical basis in this case is the concept of adaptive reactions developed in due time by the world famous scientist of the Austro-Hungarian origin Hans (Janosz) Selle. Thus, the psychological consequences of experiencing shocking or life-threatening circumstances are qualified as a “reaction to severe stress,” with the necessary clarifications in some cases: “disorder of adaptive reactions”, “prolonged reaction to grief”, etc. More on the etiopathogenesis and medical and social significance of such disorders was explained by the Lahta Clinic in the article “Post Traumatic Stress Disorder (PTSD)”.
Acute reaction to stress is the most “natural” and obvious variant of the pathological state of mentality connected with heavy stress. Let’s notice, however, that the word “natural” is taken in quotes: a pathological condition cardinally differs from a physiological one in which mobilization of all internal mental resources allows the person to handle and survive the most difficult situation (which does not exclude, however, development of PTSD later, after some months).
Data on prevalence of acute reaction to stress in different researches vary (depending on a set of factors influencing results). On average, it can be assumed that about one in ten Earthlings will have symptoms of this disorder during their lifetime.
As follows from the above, the cause of the acute (which itself implies a high rate of development) reaction to stress is always quite obvious and approachable in both space and time. It can be any personally experienced situation of life-threatening, catastrophic or shocking (even if there is no direct physical threat), excessive for the psyche: transport and ecological disasters, war crimes, criminal attacks or aggression of wild animals, rape, torture (including moral and psychological), loss of loved ones, heavy and sudden property losses, and many others – or personal presence at similar circumstances as an eyewitness.
Many researchers pay attention to the fact that an acute reaction to stress can develop not only in the victim himself, but also in his relatives and outsiders if they for some reasons perceive a situation as personally significant and identify themselves with the victim of the accident.
Risk factors includePsychophysical exhaustion (associated, for example, with age or somatic illness), physical trauma received during catastrophic events, as well as predisposing psychological traits (increased anxiety, excitability, hysteroid radical in the personal constitution, insufficient adaptive resources).
In the majority of cases, the psychopathological symptomatology starts with stunnedness and is characterized by a fast change of states – from stupor to psychomotor agitation with distorted perception of reality, grossly inadequate behavior and other clinical signs of reactive psychosis, in which the victim can represent danger to himself or others. Often, a component of “panic” vegetatics is expressed – hyperhidrosis, hyperemia of the face, total weakness, tachycardia, etc. Frequently, partial or adequate mental status is revealed. Often, partial or complete amnesia of shocking or life-threatening events is revealed.
The state of the psyche, as a rule, As a rule, the mental state starts to change with the development of a psychologically traumatic situation, or after several minutes (at most, tens of minutes) after its resolution. If the stressor has a long-term character – for example, a natural disaster with heavy victims and destruction, when aid arrives only in some days – the symptomatology of an acute reaction to stress begins to reduce spontaneously within the first or second day from the beginning of a disaster, and is minimized on the third day. Otherwise, if the psychopathological symptom complex turns out to be stable, progressive or not such in content as described above, the diagnosis “acute reaction to stress” is not made and not considered: it is a pathology of a different nature .. Transitivity, i.e. transient character, belongs to obligatory, obligatory signs of the considered disorder.
The necessary condition for establishment of the diagnosis is also absence of any other clinically verified mental disorders, which symptoms can sharply worsen and prevail in structure of a stress condition, at the same time not meeting the diagnostic criteria of “acute reaction to stress” proper. On the other hand, such reaction can also develop in persons with a history of mental disorders, without causing an essential aggravation of the underlying disease.
As a rule, the clinical picture is specific enough to be easily recognized by a specialist (psychiatrist, medical psychologist) who has arrived at the scene by accident or as part of the rescue service.
The immediate therapeutic response in the majority of cases is the administration of tranquilizers, antidepressants and/or sedatives, as well as rational anti-stress psychocorrection. If necessary, a form of group, family or individual psychotherapy can be prescribed for a subsequent period; the primary goal here is the prevention of development of the abovementioned (and described in a separate article, see) post-traumatic stress disorder, in relation to which an acute reaction to stress is one of prognostically unfavorable factors.
Treatment of acute stress
The state of acute stress manifests itself in attacks of suffocation, tearfulness, violent changes of emotions, darkness in the eyes, a state of stupor and powerlessness. Acute stress develops against a background of strong shocks – as a result of experienced disasters, natural calamities, the loss of a loved one, being on the brink of life and death. Leaving a person with such a disorder alone should not be allowed, it is necessary to immediately contact an experienced specialist.
- Death or serious illness of a loved one
- Car accident, natural disasters, terrorist attack
- Accident that occurred in front of eyes, conflict with victims
- Life-or-death situations
- Serious injury
- Severe divorce
- Dismissal from work, expulsion from high school
- Rape, beating
As we see, acute stress arises during a shock of a high degree of intensity, which, nevertheless, lasts for a limited period of time. Note that there are certain risks to the development of acute stress – as a rule, the elderly, people of any age with an anxious personality organization, people living in a state of chronic stress suffer from this disease. With acute stress, the causes require work with a psychotherapist and psychiatrist: as a rule, due to the rather strong emotional burden of events, therapy is required for a long time.
Treatment of acute stress
- Physiological symptoms. Tachycardia, shortness of breath, loss of consciousness, a feeling of nausea, sudden severe pain, “padded” extremities.
- Psychological symptoms. Hysteria, tears, deep sadness, a state of shock, aggression.
- Increased motor activity. Having experienced strong stress, the person can not sit still, he or she feels the need to move, can rush, run, walk aimlessly.
- Stupor. In some cases of acute stress the person, on the contrary, falls into a state of stupor. He can sit, looking at one point without speaking or moving for some time. Physiological processes in the body also slow down in such a state, the person may not remember what happened to him/her after leaving this state.
- Denial. In some cases – illness or death of a loved one, the patient is inclined to deny this fact (to say that the loved one did not die, to express doubts about the accuracy of the diagnosis and not accept the fact of treatment).
- Sedatives. The main feature of this class of medications is that they arrest the acute condition and do not allow the stress to develop into a more severe neuropsychiatric disorder. In addition, various symptoms of nervous tension are reduced.
- Medications belonging to the group of antidepressants. Modern antidepressants from the serotonin reuptake group act quite mildly and effectively. However, it is necessary to understand that antidepressants have a cumulative effect, so the result of drug therapy can be seen only after 3-4 weeks.
- Neuroleptics in small doses. This group of drugs is prescribed in exceptional cases, if the acute stress has a strong negative impact on the daily functioning and sleep of the patient and requires an immediate solution.
- Vitamin complexes, minerals. Doctors may recommend taking B vitamins, folic acid, omega 3 fatty complexes based on tests and medical history.
- Anxiolytics. These are drugs that relieve anxiety. Good help for people in acute stress, with an anxious psychotype.
- Sleeping pills. Modern sleeping pills are not addictive and can normalize sleep if you have difficulty falling asleep or waking frequently.
- Psychotherapy. In this case, the specialist determines the causes that led to the deterioration of the condition. Cognitive-behavioral therapy has proven effective, allowing the patient to work through the causes of acute stress and reactions to stressful events. Holistic (body-oriented) therapy can also be recommended,
- Physical activity. Through physical activity, it is possible to normalize mood, as engaging in sports helps to lower adrenaline levels and stimulate the production of endorphins. Each patient is recommended different methods and types of sports.
- Additional psychotherapeutic techniques. This can be art therapy, hippotherapy, hydrotherapy.
Prevention of acute stress
- The technique of autoanalysis of personal stress. The technique is based on self-processing of a stressful situation with the help of auto-training, relaxation and switching of attention. This technique can be taught independently or with the help of a specialist.
- Meditations. A deeper technique that allows you to direct your thoughts in a different direction and distract yourself from stressors.
- Preventive conversations with a psychologist. In the case of stressful situations and emotional reactions to them, it is recommended to visit a psychologist to prevent the development of an acute condition. He will help not only to solve the current problem, but also give the necessary psychological tools to cope with stress in the future.
- Timely resolution of conflict situations. If conflicts have arisen in the family or at work, experts recommend that you do not delay in resolving them. If the conflict drags on, the consequence can be acute stress, anxiety disorder or depression.
The consequences of acute stress
Constant exposure of the body to stress is undesirable, because the consequences may be in the form of somatic diseases and psychological disorders. Blood levels of adrenaline and other hormones are constantly elevated. As a result, such a condition quickly leads to malfunctions of the heart, to the development of diabetes mellitus, to a decrease in libido. At the same time, the immune system suffers. It is important to recognize the signs of acute stress in time and begin to get out of this state. Otherwise, it will slowly but surely kill the body, gradually reducing the body’s defenses and provoking physiological disorders.