Acute Stress Disorder and Post-Traumatic Stress Disorder

What is Trauma?

A trauma happens when someone feels threatened with serious harm, whether it is physical, mental, or emotional, and it is all too common. It can be a one-time event or happen over a period of time. If you or someone you care for has experienced gun violence in your life, you have experienced a trauma and may be suffering from one or more of its negative effects. For some people, the impact can continue over months or years and cause serious health consequences.

Trauma and the Body

In his book The Body Keeps the Score, Dr. Bessel van der Kolk talks about how the body and mind store the memories of trauma. The oldest parts of our brain help us in a “fight or flight” response to manage threats. This function was useful when we were preyed upon and at risk for being something else’s dinner. Today, that “fight or flight” response is still a function of the brain and those parts of the brain kick in when we are traumatized. For some people, this response is overly sensitive and kicks-in too frequently or at times when it isn’t useful or appropriate. This sensitivity may cause people to avoid people and places in order to manage it, which can cause people to isolate. This isolation can make the thoughts and feelings associated with trauma worse because social support is important in recovery.

Without help and support, the stress of trauma can take a toll on our bodies. Trauma is believed to cause diseases like obesity, diabetes, rheumatoid arthritis and other chronic illness. Understanding this helps in understanding that the mind and body are connected. People often recover from trauma on their own, but for some people this may not happen. If the signs and symptoms continue for several weeks or months and continue to impact daily functioning, they may develop into a mental health problem, like Acute Stress Disorder of Post-Traumatic Stress Disorder (PTSD). These disorders create emotional distress, as well as physical sensations like numbness, racing heart and irritability. If you have any concerns about how you are feeling, consult with your doctor or a licensed mental health professional.

Acute Stress Disorder

Most of the time, the negative thoughts and feelings from trauma will become less distressing without intervention. Some people, however, develop an anxiety disorder called Acute Stress Disorder (ASD). According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, ASD is short-term and happens soon after a traumatic event, lasting at least three days but no longer than a month.

Signs and Symptoms

• Numbness
• Feeling wound up (easily startled, hypervigilant)
• Re-living the traumatic event through unwanted thoughts of the event (nightmares or memories)
• Avoidance of reminders of the event (such as places, people and things)
• Negative mood and/or thoughts
• Distress

Post-Traumatic Stress Disorder (PTSD)

If a person’s symptoms continue beyond one month, they might be diagnosed with post-traumatic stress disorder or PTSD. PTSD is a mental health condition that causes the person who is traumatized to re-live the event over and over again. This re-experiencing of the traumatic event makes daily living difficult and symptoms may get worse over time. Some people show signs of PTSD six months after the trauma or later. It can happen to anyone and is not a sign of weakness, but recovering on your own without help might be hard.

Signs and Symptoms

In order to receive a diagnosis of PTSD, someone has to have been exposed to a trauma and have the following symptoms for at least four weeks:

• Feeling wound up (easily startled, hypervigilant)
• Re-living the traumatic event through unwanted thoughts of the event (nightmares or memories)
• Avoidance of reminders of the event (such as places, people and things)
• Negative mood and/or thoughts

Therapies to Treat PTSD

Cognitive Behavioral Therapy (CBT) 

Cognitive Behavioral Therapy is known to be one of the most effective types of therapy in treating PTSD. The idea behind CBT is helping you to look at how you think about a situation, maybe looking at the situation or challenging it, so you can change the way you think about it. If you can change the way you think about it, you can change the way you feel or react to it.

Medication 

Medications, such as anti-depressive medicines, are effective in the treatment of PTSD, especially when they are taken in combination with CBT.

Exposure Therapy 

Exposure therapy is used to slowly expose the person who is traumatized to the behaviors people engage in as a result of the trauma. Most of the time that behavior is avoidance. For example, if a trauma survivor is avoiding where the trauma happened, the trauma therapist will slowly expose the survivor to that location during therapy sessions. While avoidance protects us to some degree, over time it can hinder us and make the world a much smaller place. Exposure therapy should be done by a therapist who specializes in exposure therapy to reduce the risk for re-traumatization.

Eye Movement Desensitization and Reprocessing (EMDR) 

EMDR is a fairly new therapy that is thought to help people suffering from the signs and symptoms of trauma. EMDR is usually short-term and provided by a therapist who has special training. The idea is that trauma cannot be processed by the brain in a way that makes sense. The distressing effects linger because they can’t be properly filed away, so the awful thoughts and feelings cause ongoing pain.

During a session with a therapist, the client is asked to think about the traumatic event and talk about the details of the event. The therapist asks the client to keep different aspects of that event or thought in mind and to use his or her eyes to track the therapist’s hand as it moves back and forth.

While scientists aren’t sure why or how it works for some people and not for others, they do have a couple of ideas. One belief is that when a client is in the process of moving one’s eyes back and forth while retelling or thinking about the details of a trauma, they are mimicking Rapid Eye Movement (or REM) sleep. During REM sleep, it is thought that our brain is taking information and filing it away properly. So, the thoughts and feelings of a trauma are changed and the distressing effects are reduced or removed. Many people find great relief from EMDR treatment, while others try it and it doesn’t seem to work for them.

When to Seek Professional Help

If signs and symptoms continue and they interfere with everyday life, it is important to seek professional help. A counselor or therapist who is specializes in treatment for trauma, acute stress disorder and PTSD can help decrease the effects. For people who have experienced several traumas, are facing ongoing stress and/or do not have good support from a family member or friend may be more at risk for developing problems and may want to seek help sooner.

Things to Ask a Therapist

Finding a therapist who is a good fit is important. You may wish to interview several therapists before landing with someone you think you would feel comfortable with; some therapists will offer a free consultation so you can get to know one another. If you do ask for a consultation, you might want to consider asking them the following questions:

• Are you licensed to practice and in good standing with the state?
• How many years have you been working with clients?
• What is your experience working with survivors of trauma?
• Do you have experience working with survivors of gun violence?
• Do you have any areas of expertise you think would help me?
• What type(s) of treatment do you provide, and how would it (they) help me on my healing journey?
• How are you paid and how much do you charge? Do you accept insurance or do you have a sliding scale option?
• How long will counseling last?
• What do you think about medications? Do you work with a psychiatrist or anyone who can prescribe medicines if I want to explore that as an option?
• What will we be doing during our sessions?
• Do you have questions for me?

Some of the answers might not be that important to you, but they will give you an idea of the person you are about to choose. If your options are limited and you go to a clinic for counseling, you may still have the opportunity to meet with different therapists. If you don’t like the one you are assigned, ask the clinic manager if you can be re-assigned to another therapist or counselor, or if another clinic might be an option for you.

To find additional resources, please go to the Finding Help section of our web page.

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DISCLAIMER. This information does not and cannot constitute or substitute medical advice. Everytown for Gun Safety Support Fund is an organization dedicated to educating and bringing awareness around the issue of gun violence prevention, and does not provide treatment advice. This fact sheet merely provides general information and coping tips. More importantly, mental health conditions are complex, people differ widely in their conditions and responses, and interactions with other conditions and treatments are best evaluated by a physical examination and consultation with a qualified clinician. Everytown suggests that this page is a good starting point to discuss potential needs with your physician or other health care practitioner.