Traumatized?

Any individual, like the Pinoy OFWs caught in the crossfire in the Libyan unrest or those who actually experienced the recent 9.0 Japan earthquake followed by the devastating killer tsunami, may develop symptoms of Acute Stress Disorder: numbing, detachment, a lowering of awareness of the surroundings, derealization; depersonalization; re-experiencing of the trauma; difficulty experiencing pleasure and severe anxiety, including irritability, poor concentration, difficulty sleeping and restlessness.

This is a normal reaction to an extremely abnormal and traumatic experience. An acute stress disorder may develop in persons without any other prior psychiatric disorder, in response to exceptional physical and/or psychological distress. Even if the symptoms are severe, such reactions usually will subside within hours or days or even up to four weeks. The severity of the symptoms will be dependent on the individual’s vulnerability, coping capacity, history of trauma, presence of a prior emotional problem or mental illness, and the amount of emotional support. 

Following the traumatic experience, symptoms usually include an initial state of feeling “dazed” or numb followed by the inability to comprehend the situation. This state of numbness may be followed either by further withdrawal from the situation or by severe fear, anxiety and over-activity. Other symptoms are referred to as autonomic signs of arousal like tachycardia, sweating and hyperventilation.

Remember that acute stress disorder is a result of a traumatic, terrifying event in which the person actually experienced or witnessed a disastrous event that involved threat to one’s life or actual serious injury or death of others wherein the individual responded to the catastrophic event with intense fear and helplessness.

A person with acute stress disorder may have flashbacks of the traumatic event and with each flashback, it may seem as if he is again experiencing the traumatic event with the accompanying severe anxiety and feeling of helplessness. As a result, he will then try to avoid certain stimuli that can be related or associated with that particular traumatic event. A lack of responsiveness can likewise be manifested.

In majority of cases of acute stress disorder, the person may have a feeling of being uncomfortable and being unable to be responsive. This person will feel detached from various things and may become unwilling to go ahead with the recommendations or suggestions from other people. He may become unaware of his surroundings and may also be unable to concentrate on different activities and things that he should be doing. 

If the symptoms of acute stress disorder persist beyond one month, the diagnosis will then be changed to that of post-traumatic stress disorder. The diagnosis of acute stress disorder can be given only within the first month following a traumatic event. Acute stress disorder includes a greater emphasis on the dissociative symptoms. Dissociation is a reaction to the traumatic situation in which the mind splits off certain aspects of the trauma from conscious awareness. Dissociation may affect the patient’s memory, sense of reality and even his sense of identity. Acute stress disorder requires that a person experience at least three symptoms of dissociation like numbing, reduced awareness, depersonalization (a dissociative symptom in which the patient feels that his or her body is unreal, is changing, or is dissolving), derealization (a dissociative symptom in which the external environment is perceived as unreal) or amnesia. The post-traumatic stress disorder diagnosis does not include the so-called dissociative symptom cluster.

The individual with acute stress disorder may often not go for treatment because his ability to mobilize and perform his required tasks is affected. The severity of the disorder may be reduced if professional intervention (like psychosocial processing) is initiated soon after the trauma. Keep in mind that one session of psychosocial processing or debriefing is not enough. If after four sessions of psychosocial processing the patient still manifests symptoms of acute stress disorder, referral to a psychiatrist is a must. Treatment for acute stress disorder usually includes a combination of antidepressant medications and short-term psychotherapy. Cognitive behavioral therapy is said to be the most successful treatment to combat acute stress disorder.

(For questions, please e-mail me at nina.halilijao@gmail.com. Belated Happy 84th birthday to my mom,

Mrs. Remedios Musngi Warren-Halili.)