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Akute Stressreaktion

Eine akute Stressreaktion tritt typischerweise nach einer unerwarteten Lebenskrise auf, wie zum Beispiel einem schweren Unfall, plötzlichem Verlust oder einem anderen traumatischen Ereignis.

At a glance

  • An acute stress reaction is a short-term response to a very stressful event.

  • Symptoms, like anxiety or physical discomfort, usually appear quickly after the event.

  • These symptoms typically resolve on their own within a few days.

  • Self-care, talking to others, or counselling can help manage coping.

  • See a doctor if symptoms persist for more than a few days, or if you are struggling.

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What is an acute stress reaction?

An acute stress reaction occurs when a person experiences certain symptoms after a particularly stressful event. The word 'acute' means the symptoms develop quickly but do not last long. The events are usually very severe and an acute stress reaction typically occurs after an unexpected life crisis. This might be, for example, a serious accident, sudden bereavement, or other traumatic events. Acute stress reactions may also occur as a consequence of sexual assault or häusliche Gewalt.

Acute stress reactions have been seen in people who experience terrorist incidents, major disasters, or war. Military personnel are at more risk as a result of extreme experiences during conflicts.

An acute stress reaction usually resolves within 2 to 3 days (often hours).

Symptoms usually develop quickly over minutes or hours - reacting to the stressful event. Symptoms of acute stress reactions may include the following:

  • Psychological symptoms such as Angstzustände, low mood, irritability, emotional ups and downs, poor sleep, poor concentration, wanting to be alone.

  • Recurrent dreams or flashbacks, which can be intrusive and unpleasant.

  • Avoidance of anything that will trigger memories. This may mean avoiding people, conversations, or other situations, as they cause distress and anxiety.

  • Reckless or aggressive behaviour that may be self-destructive.

  • Feeling emotionally numb and detached from others.

  • Physical symptoms such as:

    • A 'thumping heart' (Herzklopfen).

    • Ein Gefühl von Übelkeit (Nausea).

    • Brustschmerzen.

    • Kopfschmerzen.

    • Bauchschmerzen (abdominale Schmerzen).

    • Atembeschwerden.

The physical symptoms are caused by stress hormones, such as adrenaline (epinephrine), which are released into the bloodstream, and by overactivity of nervous impulses to various parts of the body.

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Acute stress reaction is no longer considered to be a mental health disorder. There is no set timeline for grief or response to stressful events, and many of the symptoms described above are to be expected.

No treatment for acute stress reaction may be needed, as symptoms usually go once the stressful event is over and usually within a few days. Understanding the cause of the symptoms, or talking things over with a friend or family member, may help. However, if you are struggling, one or more of the following may help:

Self-care and practical support

If necessary, ensure that you are physically safe. Talking things over with family, friends, or a professional can help. Regular exercise, healthy diet, regular sleep, and limiting caffeine and alcohol are good for your general mental health.

Although alcohol may apparently give short-term relief of symptoms it can be damaging. Drinking alcohol to 'calm nerves' may lead to problems with low mood, worse anxiety and problem drinking and is not recommended.

You may wish to contact your doctor or other healthcare professional for practical support, connection with social support, information about self-care and coping strategies, or referral for psychological therapies.

Kognitive Verhaltenstherapie (KVT)

CBT is a talking therapy and is based on the idea that certain ways of thinking can trigger or fuel certain mental health problems. It is the treatment of choice for acute stress disorder.

Beratung

Counselling helps you to explore ways of dealing with stress and stress symptoms. This may be available locally but some charities also offer online resources and helplines that may be useful. Some organisations specialise in bereavement counselling.

However, not everyone needs to process trauma as soon as possible after the incident. Indeed, interventions such as Psychological Debriefing immediately after trauma or critical incidents can make things worse, and are not recommended.

Medikamente

Generally, medications are not as effective as psychological therapies in treating acute stress disorder and should not routinely be used.

A Betablocker is one medicine that can help relieve some physical symptoms that are caused by the release of stress hormones. Beta-blockers are not addictive, are not tranquillisers and do not cause drowsiness or affect performance. You can take them as required.

Sometimes, medications are given to help with specific problems like lack of sleep, pain, or depression, but you should discuss these with your doctor.

Some people who have an acute stress reaction will find their symptoms persist for longer than one month. It may be necessary to discuss these symptoms with your doctor. There may be another explanation for your symptoms. Some people with long-term symptoms may need to be assessed to see if post-traumatic stress disorder is a possibility.

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If symptoms of an acute stress reaction last longer than three days but less than a month, this is called an acute stress disorder (ASD). Acute stress disorder is not universally recognised as a medical condition and what you are experiencing may still be a normal or appropriate response for you, in your circumstances.

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Häufig gestellte Fragen

If an acute stress reaction isn't considered a mental health disorder, why are treatments like CBT mentioned?

While an acute stress reaction is no longer classified as a mental health disorder, some people still struggle with the symptoms. Treatments like Cognitive Behavioural Therapy (CBT) are discussed as options for those who need extra support, especially if their symptoms are persistent or particularly disruptive. These interventions aim to help manage the feelings and thoughts triggered by the stressful event.

Can certain professions or experiences make someone more likely to have an acute stress reaction?

Yes, certain experiences can put individuals at higher risk. For example, military personnel are more prone to acute stress reactions due to the extreme experiences they may face during conflicts. Similarly, people involved in terrorist incidents, major disasters, or other severe events are also at increased risk.

What kind of practical support is available if I'm experiencing an acute stress reaction?

Practical support involves ensuring your physical safety first. Talking things over with friends, family, or a professional can be helpful. It's also recommended to maintain a healthy lifestyle, including regular exercise, a good diet, sufficient sleep, and limiting caffeine and alcohol. Your doctor can also provide information on self-care strategies or connect you with social support.

Are there any specific situations where psychological debriefing immediately after a traumatic event is not recommended?

Yes, interventions such as Psychological Debriefing, when conducted immediately after a trauma or critical incident, can actually make things worse. The article specifically states that these are not recommended, as not everyone benefits from processing trauma so soon after it occurs.

How can I tell the difference between typical acute stress reaction symptoms and something more serious like acute stress disorder or post-traumatic stress disorder?

An acute stress reaction usually resolves within 2 to 3 days. If your symptoms last longer than three days but less than a month, it might be classified as an acute stress disorder (ASD). If symptoms persist for longer than one month, it's advisable to discuss this with your doctor, as there might be another explanation, and they may need to assess you for the possibility of post-traumatic stress disorder (PTSD).

The article mentions medication for specific problems like poor sleep. What kind of medications are generally used for acute stress reactions?

Generally, medications are not as effective as psychological therapies for acute stress reactions and are not routinely used. However, beta-blockers can be helpful for some physical symptoms caused by stress hormones, as they are not addictive and don't cause drowsiness. Sometimes, other medications may be prescribed for specific issues like lack of sleep, pain, or depression, but these should always be discussed with your doctor.

Weiterführende Literatur und Referenzen

  • Rose S, Bisson J, Churchill R, et al; Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2002;(2):CD000560.
  • Anxiety disorders; NICE Quality Standards, Feb 2014
  • Rahnama M, Shahdadi H, Bagheri S, et al; The Relationship between Anxiety and Coping Strategies in Family Caregivers of Patients with Trauma. J Clin Diagn Res. 2017 Apr;11(4):IC06-IC09. doi: 10.7860/JCDR/2017/25951.9673. Epub 2017 Apr 1.
  • Bryant RA; Acute stress disorder. Curr Opin Psychol. 2017 Apr;14:127-131. doi: 10.1016/j.copsyc.2017.01.005. Epub 2017 Jan 18.
  • Kavan MG, Elsasser GN, Barone EJ; The physician's role in managing acute stress disorder. Am Fam Physician. 2012 Oct 1;86(7):643-9.

About the authorView full bio

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Dr Suchita Shah, MRCGP

Allgemeinmediziner und Facharzt für öffentliche Gesundheit

MRCGP, MPH, MA (Cantab), MPhil, BMBch (Oxon), DCH, DFSRH, DRCOG

Dr. Suchita Shah ist Hausärztin, Spezialistin für Bevölkerungs- und globale Gesundheit, Schriftstellerin, Redakteurin und medizinische Ausbilderin.

About the reviewerView full bio

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Dr Colin Tidy, MRCGP

Allgemeinmediziner, Medizinischer Autor

MBBS, MRCGP, MRCP (Paediatrics), DCH

Dr. Colin Tidy ist ein NHS-Arzt mit Sitz in Oxfordshire.

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