Acute stress reaction

Comprehensive Guide to Acute Stress Reaction

All people have to cope with tragic strokes of fate in the course of their lives. But if the experiences are so drastic for the person concerned that they can no longer be coped with with the body’s own mechanisms, then there is an acute stress reaction .

What is an acute stress reaction?

Experienced traumas can push the human psyche to its limits and overwhelm it. A crisis situation then arises – the acute stress reaction.

An acute stress reaction is first and foremost a normal response of the human psyche to a stressful experience in life. For this reason, it is not a disease.

Rather, it is an expression of an extraordinary emotional burden for which those affected cannot find an adequate coping strategy. The body’s own coping mechanism fails because the stress is too extreme. As a result, there are a multitude of symptoms, which are expressed on both a psychological and a physical level.


The acute stress reaction can be observed especially when a person has personally experienced or has experienced violence. Regardless of whether experiences of war, physical or psychological violence play a role. All these traumas experienced can bring the human psyche to its limits, overwhelm it. A crisis situation then arises – the acute stress reaction.

In addition to the death of a loved one, experiencing serious accidents can also trigger such a reaction. Of course, the reaction to a difficult event also depends on the individual’s psyche. An acute stress reaction can occur even if the experience from the outside is perhaps not perceived as serious.

Symptoms, ailments & signs

Immediately during and after the stressful event, the person concerned is numb. She has the feeling that she is not herself, perceives herself as though through a filter. This phenomenon is called depersonalization . This goes hand in hand with those affected behaving strangely and performing seemingly senseless actions.

The psychological impairments in this phase include impaired perception , disorientation and narrowing of consciousness. The person is in shock . In addition, there are strong mood swings . If the person is full of grief in one moment, they can lash out with anger the next and sink into apathy a little later .

The psychological tension then also hits the body. Sweating , racing heart and nausea can be associated with an acute stress reaction. Furthermore, the person may be tormented by violent nightmares and recurring memories of what they have experienced. Sleep disorders , reduced sensitivity and increased irritability are also characteristic of this crisis situation .

Diagnosis & course

In the acute phase, i.e. the time during and shortly after the occurrence of the stressful event, the person concerned is like a different person. His personality changes, he behaves strangely and deviating from his normal behavior. Other people find it difficult to get hold of him, also because of the extremely pronounced emotional mood swings.

The acute reaction to a bad event can last for hours to days, in extreme cases even weeks. In the acute phase, other symptoms occur than in the subsequent processing phase. In the processing phase, memories of the bad event keep coming back. Sleep can be disturbed and nightmares are common. What happened is processed day and night.

During this time, the person concerned is more irritable and more frightened than usual. In the processing phase, the symptoms decrease in intensity and sooner or later disappear completely. However, if the typical symptoms last longer than four weeks and intervene deeply in the person’s everyday life, the acute stress reaction has become a post-traumatic stress disorder . This should definitely be treated with psychotherapy because, in contrast to the stress reaction, it is a disease.


The acute stress reaction can also have psychological consequences over the acute period. As it progresses, it may develop into post-traumatic stress disorder or adjustment disorder. However, other mental illnesses are also conceivable as a result of the mental shock: The heavy stress can serve as a trigger for disorders for which a predisposition is already present.

Such critical life events may also trigger a relapse into previous mental illnesses or destructive thought and behavioral patterns. In addition, some people who suffer from mental shock pose a temporary danger to others or to themselves. In some cases, targeted self-harm, such as cutting, burning, pulling hair, or being blunted, occurs. Suicidality can also occur.

Aggression is another possible complication of the acute stress response. The person can temporarily appear completely alienated and no longer be themselves in character. If the acute stress disorder is treated incorrectly, complications are also possible.

A too early confrontation with the traumatic event may have a re-traumatizing effect: Instead of working through the trauma , it is mentally relived and solidified. Violent and insensitive reactions to aggressive or self-damaging behavior can also represent an additional burden for the person concerned or even have a traumatic effect themselves. For this reason, a cautious approach is required.

When should you go to the doctor?

If the person concerned is an imminent danger to themselves or to other people, professional help is required. Persistent or strong thoughts of suicide, self-harm, or physical violence towards others are examples of such situations. The first contact can be made through the family doctor . Anyone who is already being treated by a psychiatrist or psychotherapist for other reasons can also contact them directly. In Germany, no referral is required for an appointment with a psychiatrist or psychotherapist.

Many crisis situations come to a head in the late evening or at night. In most of the larger cities there are therefore crisis intervention services that can be contacted in the event of a mental emergency. Especially in the case of very strong, pressing thoughts of suicide, those affected can also turn to the emergency room of a hospital if there is no specialist clinic on site for acute cases in which admission is also possible at night.

It is not always necessary to consult a doctor or psychotherapist in the event of an acute stress reaction. For example, a visit to the doctor is usually not necessary if the heavy exposure lasts for less than two weeks and there are no other urgent reasons (e.g. suicidality).

A low-threshold counseling service is offered by telephone counseling, which can be reached free of charge in Germany on the nationwide telephone number 0800 111 0 111 around the clock.

Treatment & Therapy

In the case of the acute stress reaction, no help needs to be sought at first. First of all, it is completely normal for the person affected to develop severe symptoms. However, these should disappear on their own after a few weeks during the processing phase. But if this does not happen or if the person is in such a desperate state, then professional help should be sought.

Psychotherapeutic treatment by an experienced therapist is indicated here. Three phases can be distinguished in the course of therapy: the stabilization phase, the confrontation with the event and the integration phase. The first part tries to calm the affected person emotionally and to give him a new perspective. The goal is to get him out of the desperate state.

The trauma confrontation is about making the affected person aware of what happened in detail. By reporting the event, he can process the trauma in great detail. In the third part, the integration phase, the person affected is helped to resume normal life. Relatives can also be included in the therapy.

If the person concerned has major problems coping with everyday life, the use of antidepressants and sedatives has proven effective. In the event of a traumatic experience, the person can be helped with two measures. On the one hand with the psychological first aid, with which the person is supported by a competent contact person while the action is taking place.

On the other hand, with the delayed psychological early intervention, which aims to alleviate symptoms and prevent post-traumatic stress disorder.

Outlook & forecast

It is not always possible to react correctly to an acute stressful situation. Traumatic experiences often only make themselves felt later through an acute stress disorder or a post-traumatic stress syndrome. In this case, the prognosis is only good if the person concerned turns to a specialist with confidence. If he increasingly withdraws because of his problems, the acute stressful situation can turn into a dangerous situation. It can lead to depression and suicide.

Even an acute stressful situation can feel dramatic. Ignored, it can lead to burnout or a nervous breakdown. It is therefore all the more important to react immediately to acute stress. Talking about it and seeking help can often defuse the situation. If stressful situations last a few days, the outlook is worse. The acute situation has turned into a disorder. The extent to which this requires treatment varies.

Symptoms of stress disorder can often be alleviated through conversation. If those affected do not want to burden their families with this, a psychological day clinic is the right place. The long waiting times for psychological treatment often make the situation worse. The family doctor is best able to decide when medical intervention is necessary and when medical help might be sufficient.


Since the acute stress reaction is not a disease, but a response of the psyche to a traumatic experience, there are no preventive measures that could be taken in advance.


Follow-up care usually only takes place if a serious experience has occurred and the person concerned cannot foreseeably not be able to process all the circumstances. In this case, a post-traumatic stress disorder threatens to develop. Complaints keep recurring.

The actual therapy is the responsibility of a psychologist or psychotherapist. These sometimes prescribe supplementary medication that supports the self-healing powers. The aim of treatment is to avoid complications. In a pronounced form, an acute stress disorder can lead to suicide.

In such a case, inpatient accommodation is necessary. Often the immediate environment contributes to how quickly a recovery succeeds. Follow-up care is not only aimed at making everyday life easier and eliminating complications. Rather, it is also about preventing a recurrence. Depending on the severity of the illness, the treating family doctor will make an appointment for a new assessment.

However, this is the exception after a final recovery. Instead, the patient is discharged as cured. If an acute stress disorder occurs due to another event, he must start therapy again. Those affected cannot prevent a recurrence. The body’s own coping mechanism can fail at any time.

You can do that yourself

The acute stress reaction is a temporary mental illness that can lead to restrictions in social, professional and family life. Depending on how severe the acute stress reaction is, the person concerned may be unable to work. In this case, it is possible, for example, to leave your doctor on sick leave .

Affected people who do not live alone can inform roommates or family members about the acute stress reaction. This way, they can ask for support or consideration, for example. If possible, those affected should clearly communicate whether and how family and friends can help them. Everyday life with an acute stress reaction is often characterized by a high level of stress . Resources can help reduce this stress. This includes social resources (such as family, friends, etc.) as well as practical opportunities for distraction, sports and things that are good for the general person.

Although an acute stress reaction is a temporary condition, it can persist as a post-traumatic stress disorder or promote other mental illnesses. For this reason, it makes sense to closely monitor the acute stress reaction and to seek professional help in good time. Few of those affected find a place with a resident psychotherapist in a timely manner. In the case of severe symptoms or suicidality , it is therefore advisable to consider inpatient treatment or to consult your family doctor first.

Acute stress reaction

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