We asked Treatfield experts about acute stress response — a condition that we regularly encounter in the news and, unfortunately, in our daily lives. What is this condition, how can we recognize it, and how can we get through it with minimal harm to ourselves?
The term "acute stress reaction" frequently appears in the news. But what exactly does this concept mean? What is this condition, and what are its symptoms?
Gestalt therapist Kateryna Rozhkova
An acute stress reaction is a physiological (physical) and/or psychological response to events or phenomena that are overwhelming and unexpected, such as accidents, the sudden loss of a loved one, explosions, or acts of violence. Military personnel, due to their exposure to extreme experiences during conflicts, are often at greater risk.
The word "acute" signifies that the symptoms develop rapidly but typically do not last long, ranging from a few hours to a few days. An acute stress reaction is often referred to as psychological shock, or simply shock. The brain essentially presses an "alarm" button, sending signals throughout the body to initiate protective responses. This reaction can be quite intense and frightening, yet it is a normal response to an abnormal situation.
The psychological symptoms of an acute stress reaction may include:
- Anxiety
- Irritability
- Emotional swings
- Disturbed sleep
- Poor concentration
- A desire for solitude
- Recurring dreams or intrusive and unpleasant flashbacks
- Avoidance of anything that might trigger memories of the situation or event (often accompanied by physical sensations and fear)
- Reckless or aggressive behavior, which may be self-destructive
- Feelings of emotional numbness and detachment from others
Physical symptoms include rapid heartbeat, nausea, chest pain, headache, abdominal pain, and difficulty breathing. These are caused by stress hormones released into the bloodstream and excessive nerve impulses to various parts of the body.
Perhaps, as you read these lists of symptoms, you recall extreme situations from your own experience and your reactions to them, allowing you to identify your individual characteristics. Several symptoms may be present simultaneously, with psychological symptoms often accompanied by physical ones.
It's worth noting that medical reference books present two primary points of view regarding the duration of these reactions.
According to the first, an acute stress reaction can persist for up to a month. The second perspective offers a conditional division: an acute stress reaction (where symptoms typically subside after the stressful event ends, within 2-3 days, often just hours) and acute stress disorder (where symptoms last longer than 3 days but less than a month). However, acute stress disorder is not a universally recognized medical condition, and what you are experiencing may still be a normal or appropriate response for you, given your circumstances and individual characteristics.
Such conditions can be exhausting. Therefore, it is advisable to focus on physical exercise or walks, prioritize a balanced diet, ensure adequate sleep (as much as possible), and limit caffeine and alcohol, as they can exacerbate anxiety. If necessary, consulting a specialist is recommended.
In some individuals, symptoms of acute stress reactions may persist for longer than one month. In such cases, it is essential to consult a doctor for further diagnosis and examination, as well as for the early detection of other potential medical conditions like adjustment disorders or PTSD.
Disclaimer: This information is intended to raise societal awareness about psychological conditions and problems. It should not be used for self-diagnosis and/or treatment. For diagnosis and treatment, it is always recommended to consult a qualified specialist.
How should I behave and what should I do if someone next to me has an acute stress reaction? What techniques can be used to alleviate their condition?
Gestalt therapist, Art therapist Svitlana Prystupliuk
Sometimes, we might witness someone seemingly "break down" right before our eyes. They might start shaking, crying, or screaming, or, conversely, freeze, become unresponsive, or appear disconnected from reality. Such behavior can be confusing and even frightening to those around them. Yet, this behavior is often an acute stress reaction (ASR).
An ASR is a normal psychological response to abnormal circumstances. It's a short-term condition that occurs immediately after a traumatic situation. For instance, it can happen after the loss of a loved one, an experience of violence, a significant injury, or an accident. It can even occur simply by witnessing another person experiencing trauma. In these moments, the mind doesn't have time to process the event, shifting instead into a survival mode.
What are the Signs of an Acute Stress Reaction?
First, you'll likely notice behavioral changes. For example, a person might become extremely restless or, conversely, abruptly freeze. They might also try to flee or avoid reality as much as possible. Complete silence and a lack of any reaction when you speak to them are also common. Extreme stress can even lead to fainting.
Physically, an ASR can manifest as tremors, nausea, numbness, a rapid heartbeat, and heavy, uneven breathing. Emotionally, there are two distinct possibilities: a vivid expression of emotions (like screaming, crying, or hysterics) or a complete absence of any emotions, giving the impression that the person has "frozen." Cognitive processes will also be challenging; the person may feel disoriented, "as if in a dream," struggling to find the right words or answer questions logically.
How can you help?
Once you've determined that someone is experiencing an acute stress reaction, the question becomes: what should you do to help?
- First and foremost, assess your own state. If you also feel destabilized and need assistance, prioritize taking care of yourself. If you feel you have enough resources to help, here are some simple but effective strategies:
- Offer, but don't insist. Ask if they need your help. Try to speak clearly and calmly, without pressure. Say things like, "I'm here if you want me to be," "Would you like some water?", "Can I get you a blanket?", or "Can I hold your hand?" Sometimes, this gentle offer is enough.
- Simply be there. Often, that's all it takes. You don't need to be a psychologist or therapist; just your presence can be profoundly helpful. A simple "I'm with you" or "I'm here" is often the best thing you can say.
- Avoid promises or advice. Phrases like "everything will be fine," "calm down," "why are you reacting like that?", or "don't cry" are counterproductive. They aren't about helping; they're about judging or dismissing their feelings. Instead, try saying, "I can see this is difficult for you. I'm here for you."
- Encourage calm breathing. Your calm, deep breathing can provide a sense of security. Offer to breathe together: "Breathe with me. Inhale — one, two, three, four. Exhale — one, two, three, four." A few such cycles can significantly improve the situation, as breathing is often severely impacted during an ASR.
- Don't rush them. Give their mind time to regain control. Avoid asking "what happened?" as their brain isn't capable of logical thought in that moment.
- Help them return to reality. Encourage them to look around and draw their attention to concrete things in the present moment. Say things like, "Look how green the grass is. You're wearing a blue sweater," and so on.
The "5-4-3-2-1" Technique
This grounding technique can be very effective:
- Name 5 things you can see around you (e.g., table, chair, carpet).
- Name 4 things you can touch (e.g., your hand, a book, a pen).
- Name 3 sounds you hear (e.g., someone's voice, the sound of a car, your own breathing).
- Name 2 smells (e.g., cut grass, perfume).
- Name 1 taste (e.g., the taste of gum, coffee, or candy).
An acute stress reaction usually resolves within a few hours or days. However, if the condition doesn't improve, or if the person experiences persistent sleep disturbances, nightmares, excessive anxiety, or flashbacks (vivid memories that make the traumatic situation feel like it's repeating), these may be symptoms of acute stress disorder or PTSD. In such cases, it's crucial to consult a psychotherapist.
You don't need to be a specialist to offer support. Simply staying close, remaining calm, avoiding pressure, and not leaving the person alone can make a significant difference. Often, calm breathing nearby and offering water or tea are the first, most effective remedies.
How can I tell if I am experiencing what is known as an “acute stress reaction”? Can I help myself with this condition on my own?
Gestalt therapist Alla Lipovets
An acute stress reaction (ASR) occurs when the intensity of a stressful event overwhelms your mind's immediate ability to cope.
Think of it like an internal container designed to hold 10 kg suddenly being overloaded with a ton of emotions. The system becomes completely overwhelmed, and it simply needs time to recover.
It might be easier to understand this process by considering a snake that swallows large prey whole and then lies motionless for several days, digesting it. Something similar happens to your mind: if something too significant occurs that cannot be "digested" immediately, your body might freeze. This slowing down of all processes is primarily a protective mechanism, giving your mind the necessary time to process and experience what has happened.
It's important to note that our lives are often filled with stressful events. Therefore, an ASR can arise not only from a large-scale traumatic event but also from something seemingly less serious that became the "last straw," accumulating with existing stress and finally knocking you off your feet.
How to tell if you're having an acute stress reaction
The main indicator of an ASR is the presence of a "starting point": a specific event after which your condition sharply deteriorated.
This condition can affect all areas of your body's functioning:
Physical symptoms may include a rapid heartbeat, shortness of breath, nausea, tremors, sleep disturbances, and muscle tension.
Cognitive signs include difficulty concentrating, memory impairment or lapses, and disorientation in time and space.
Emotional reactions can manifest as derealization—the feeling that everything is unreal or not happening to you—severe anxiety, panic, or, conversely, apathy and a feeling of complete detachment from the situation.
It's crucial to understand that people react very differently. Some may freeze and become silent, while others, conversely, become overly active, emotional, or irritable. All of these are normal reactions of the body to abnormal events.
What you can do for yourself
The most important thing is to give it time.
Your mind needs space and peace to cope. It's essential not to rush yourself, avoid self-pressure, and resist the urge to "pull yourself together."
The simple human presence helps: someone who can be there without asking questions, without insisting, but simply being present.
Support in this moment can also come in very ordinary forms: ensuring adequate sleep and food, having hot tea, taking a shower, putting on warm clothes, being in a calm environment, and receiving support from loved ones.
Any grounding techniques can be useful, such as focusing on bodily sensations, breathing, and being present in the "here and now."
An acute stress reaction is a temporary condition, and the intensity of symptoms usually begins to decrease after a few hours or days.
However, if your condition remains just as severe after a few days, interferes with your normal functioning, or worsens, then this is a clear reason to seek professional help. Early intervention can help prevent the development of post-traumatic stress disorder (PTSD). A specialist can provide careful and safe guidance through these experiences and offer crucial support.
And most importantly: you are okay. If you are experiencing an acute reaction to stress, it is not a sign of weakness. It simply means that you are a person navigating difficult times, and your mind is doing everything possible to protect and adapt.
What consequences can an acute stress reaction have for a person? Will post-traumatic stress disorder necessarily develop afterwards? Should you seek help, or can you expect it to “go away” on its own?
Gestalt therapist Nataliia Kudriavchenko
An acute stress reaction is when the body remembers, but the mind wants to forget.
There are moments when it seems that the world has cracked. It's as if something has happened — externally or internally — and after that it is impossible to return to “how it was.” It could be an accident, a suicide bomber nearby, a sudden loss, a diagnosis. Anything that calls into question safety, integrity, life itself. At such moments, the body mobilizes: breathing becomes irregular, muscles tense, space narrows. Or, conversely, a kind of numbness sets in: it is as if you are looking at yourself from the outside and feeling nothing. This is an acute reaction to stress — the mind's natural response to something that exceeds its ability to cope in the moment.
This is a normal reaction. It can last from a few hours to several days and can pass on its own if there is support, the body can feel safe again, and experience emotions. If the psyche and body feel that there is no longer a threat.
But sometimes it does not go away. A person seems to go on living, but part of them is stuck in that moment. It can be difficult to sleep. Memories return. Anxiety, hyperarousal, and avoidance of any reminders of the event appear. If this lasts for more than a month, we can assume the possibility of post-traumatic stress disorder. It does not necessarily develop in everyone who has experienced a traumatic event. But the risk increases if there was no opportunity to live through the experience — that is, to give it a place, name it, feel it, share it in the presence of another person who is not afraid of your pain. With someone, in safety, in contact.
But sometimes it happens differently. The event seems “insignificant,” but the reaction is so strong that you cannot ignore it. It hurts unexpectedly. An evening after which you can no longer sleep. A glance that triggers an old memory. A phrase that broke through your defenses. It is no longer just about the present — it is about something older that has remained buried. It's such a “small” situation that it doesn't seem to be related to the event, and it's not clear why the reaction is so violent and why it hurts so much and feels so bad “out of the blue.” And it literally shakes your whole body because it touches a wound that was created a long time ago, most likely a very long time ago.
Is it worth seeking help? If something hurts inside and there is no place nearby where you can find comfort — yes. This is not a sign of weakness. It is a sign that you are in pain and deserve support. That you don't have to be alone with this right now. And that caring, humane contact can sometimes do more than “forgetting and moving on.”
