Acute Stress Disorder
Anyone who lives through a traumatic event can experience an extreme psychological reaction to the trauma. They can have a particularly strong response to a stressing event such as a loss, threat of death, serious injury, abuse, being sexual violated or a natural disaster.
Children not only re-experience the trauma or stress, but they can feel numb, scared, and need more soothing then normal, or they can appear nervous. Teens who also go through traumatic events may experience Acute Stress Disorder like children but may show different signs.
Teens can be detached, emotionally unresponsive or like children can have nightmares where they are reliving the trauma. They can experience a reduced awareness of what is going on around them, feel as though what they are thinking, or feeling is not real or wrong, and they can even experience loss of memories from the traumatic event.
Sadly, without being directly involved in the trauma, by watching television and other media sources, or by witnessing trauma, our children and teens can still develop acute stress disorder. Hearing someone else’s story can also induce acute stress as well, especially if they are already feeling their own stress. Although anyone can experience acute stress disorder, children and teenagers are much more susceptible to acute stress/post-traumatic stress disorder than adults.
As parents, counselors, relatives and friends of children and teens who experience trauma, it is our job to decrease the importance of this life changing event help them process what happened, show them relaxation techniques most beneficial for them and help them focus on other happier things in their lives.
By offering resources and techniques, and by letting them know someone is always there when they need something or want to talk, this will help them focus on more positive things and maybe even reach out for professional help. If acute stress disorder goes untreated (within a month of the event), it manifests into the lasting effects of post-traumatic stress disorder (PTSD). ASD covers symptoms within the first month after the trauma occurred, if these symptoms continue it is then PTSD. Post-Traumatic Stress Disorder if left untreated can last and traumatize the survivor for years after the original event.
The effects of ASD on a person can all depend on the trauma experienced, how quickly they are treated, the feeling of interpersonal connectivity, family collaboration and the survivor’s cooperation.
The survivor’s reactions to stress can also vary with experience. This means when there is no intervention and the survivor experiences constant reminders of the trauma, feels loss or additional stress is felt, side effects can become more intense and take longer to treat when they do reach out for help.
There are 4 categories and side effects from Acute Stress below. This will hopefully help you be more vigilant if you see this happening to someone you know who a survivor of trauma is:
Intrusive symptoms – unwanted thoughts or images about the event, that are unwanted and tend to occur frequently right after the event and can continue/magnify if left untreated.
Flashbacks- these can create a sense of reliving the trauma over and over
Traumatic nightmares-
they can experience distress of many degrees when faced with anything that reminds them of the event
Some Other Intrusive Feelings Can Include:
-fear of others finding out
-anxiety or panic attacks
-loss of appetite
-distress
-numbness or feeling detachment
-feeling as though they are in a daze
Other Symptoms Can Include:
* Negative mood/affect
* Inability to feel or experience happy or feelings of guilt for doing everyday things
* Experience high avoidance, evade everything familiar to event
* startle effect
* Difficulty concentrating and sleeping
* Inability to sit still
Going through a traumatic event can take a big toll on the person experiencing it. It can be especially trying for children and teens with all the other stressors they have going on in their lives.
When we do our best to show and let them know we are there for them, help them keep their routines as normal as possible, give them extra support at bedtime and when schedules are changing. Children and teens, although they may say they don’t want our help or try to push us away, they need to know they have our support.
They need to feel their normal again, be ok and what happened to them is not their fault. If they reject opening to you, find an activity they enjoy and ease into the conversation. Reaching out to a counselor can relieve some of all your stress and you can tell them you found someone they can open up to and the way they are feeling can be managed with appropriate intervention.
What’s Next?
Other, more serious side effects of ASD:
Derealizationwhere things seem almost unreal or not happening,
Depersonalization where the teen feels as though their thoughts or feelings are not their own,
Dissociative amnesia where they cannot remember certain parts of the trauma effectively.
In the first 4 weeks after the teen experiences the trauma symptoms displayed are diagnosed as Acute Stress Disorder. Consequently, if these experiences continue or become dramatically worse, they may then be diagnosed with
Intervention with the help of a counselor and loved ones can assist with not only dealing with traumatic event, the pain and emotions involved and side effects but possibly avoid a relapse.
People who experience a traumatic event can learn how to anticipate and deal with their triggers, while developing the needed skills such as:
- problem solving and goal setting skills (solution-focused therapy),
- emotional regulation,
- the use of outside interpersonal support (counseling)
So now that we hopefully understand a little more about what ASD is and how to prevent it from becoming PTSD, here is a small overview of the things we should be watching for in our children, teens and others that we know who have been through any sort of trauma.
Overview of the Signs and Symptoms of Acute Stress:
An assessment for ASD should be done by a licensed professional.
Post Traumatic Stress Disorder or PTSD
Without some type of intervention teenagers can experience PTSD
Several more severe symptoms will be displayed extreme flashbacks, nightmares as with ASD but risky or destructive behavior, extreme negative thoughts about oneself or the world around them and exaggerated blaming themselves or others for causing their trauma.
Resolution Using Cognitive Behavior Therapy:
To prevent ASD from turning into PTSD teenagers need effective and caring intervention immediately or very shortly after the trauma.
Studies done have shown Cognitive Behavior Therapy to be one of the most effective interpersonal trauma, vehicle accidents, victims of sexual trauma and interpersonal violence.
CBT involves discussing the teen’s feelings and thoughts about the event so that they learn to think differently about it.
Some cases resolve themselves, but others can progress into the more impairing and long-term PTSD.
Access to the Road of Recovery
Research has shown the Cognitive Behavior Therapy related therapies may speed recovery and prevent PTSD when given to the teen over a few sessions within 2-3 weeks after trauma exposure.
Treatment for teens with ASD needs to be a collaborative effort among the teen, their parents, their teachers, counselors, and friends/family.
CBT can find the positives in conjunction with visualization that with practice, helps the teen deal with the trauma.
Minorities and Acute Stress Disorder:
Acute stress disorder can develop and be experienced by anyone from any culture.
However, treatment may be an obstacle for some from diverse backgrounds because outside intervention may be perceived as having an ulterior motive or go against their traditional beliefs.
As the DSM 5 states, the appearance and display of symptoms of Acute Stress vary among diverse and cross-culture teens.
There is an increased risk of suicidal ideations and attempts. This increased risk along with the Acute Stress Disorder can increase because of their lack of access to services.
Not knowing the feelings or obstacles are due to ASD can cause bigger problems for these teens. Many times, they have been taught not to talk about their problems or concerns with others. Some cultures may display trancelike symptoms in the 1st month after trauma exposure.
Cognitive Behavior Therapy can have a clear impact on development and early treatment of ASD, in all cultures, may significantly reduce a teen’s chances of developing PTSD.
Teenagers from Trauma to Positivity through CBT
A type of therapy that has been implemented with teenagers and has them focus on their positive attributes and strengths is Positive CBT.
This is more in line with the more personalized approach taken by CBT as opposed to earlier treatments for ASD, anxiety, depression or other mental health disorders. If teens can find the vast array of things positive and right about themselves, they learn the needed coping skills for challenges and conflicts.
CBT encourages teens to reflect on their feelings by writing them down and focus on their own judgement and goals over time.
Counseling teens can be challenging at times, and difficult if traditional therapy becomes a barrier when trying to communicate.
Your average teen dealing with everyday issues can display resistance. When engaging with teens dealing with trauma it can become a bigger challenge.
Counselors need to equip themselves with creative techniques to encourage teens from all ethnicities through verbal and non-verbal expression and engagement in a non-traditional way.
Activity that parents, teachers and counselors can help teens with ASD and can be done anywhere
Through the research I did for information regarding teens and Acute Stress Disorder, in one form or another this technique, whether you call it Visualization, Relaxation, Mindfulness or Grounding in its many variations was HIGHLY recommended and proven to be quite effective.
Many teens may think this activity or others are dumb, they do not have the time or think it won’t work. With consistent support and practice using activities similar to this mindfulness, visualizing or whatever you want to refer to it as, has been proven to decrease symptoms.
Activity Warm-Up:
Tension, anxiety, and fear are very common after crises. These feelings can make it more difficult to work on what is needed to recover.
There is always journaling, going for a walk, exercising but to get through and help a teen who is experiencing ASD experts have found:
Using relaxation techniques dramatically help teens calm down and help with sleep, concentration and minimize panic attacks:
Children/Teens- This can be done with or without music:
- Inhale slowly
- As you inhale say to yourself: I am ok, I am filling my body with calm
- Breathe out slowly while you count in your head: 1,2,3,4, 5
- Silently say to yourself, I am letting the ____, tension, fear etc, go away
- Repeat 5 times slowly
Creative Mindfulness for Our Children and Teens:
Children may be a little more happy and adaptable to trying these but with trial and error, even the most stubborn of our teens may see this as a silly relief, a step to feeling better.
This process is something you would use when you find yourself stressed, scared hurt, or other unwanted feelings. It’s going to be easy, nothing to worry about, all you need to do is relax. (Yes, and I know sometimes this can be easier said than done)
So, how about we start off with you getting comfortable and taking a few deep breaths.
Now take two more breaths, breathing in deeper than you normally would. Relax deeper and deeper.
If you are comfortable, close your eyes, otherwise, just relax as much as you can, it does get easier the more you practice.
Imagine something that makes you happy, something you would like to happen or accomplish. It can be going out with friends, playing sports, going to a party, or spending time with family. Picture this happy event as clearly as you can in your mind.
Now in your mind, surround this idea with a pink bubble. Your surroundings and this pink bubble are making you feel very at ease and relaxed. Pink is the color that symbolizes the heart. Imagine the bubble is transporting you to your ideal happy place.
As it approaches somewhere happy from your memories, or anywhere you’ve imagined wanting to go, you feel at ease. It can be a beach, your grandmother’s house, or anywhere you like.
You see the bubble open, in your happy place.
Look around and take in the sights. What do you see? Take a few minutes and focus on as many details as you can. For the beach, you can envision the waves as they go in and out, the sand beneath your toes, and for your grandmother’s house, envision her before you, the furniture and the lighting in the room. Just take it all in for a few minutes.
Now look around you and touch a few items. You can note the feeling of the sand or water at the beach, the texture of a fresh-baked dessert, or whatever else you can touch. Take a few minutes to touch a few items that resonate with you.
What do you hear? Do you hear birds, or maybe the rush of the water, or something cooking on the stove? Just listen for any sounds you hear in your happy place.
Think about the smells around you. Do you smell the crisp air or the smell of fresh-baked cookies? Take a few minutes to find a few pleasant smells in the air.
Finally, before we return, let’s take just a few minutes and experience a taste, here in your happy place. Can you taste the saltiness in the beach air? Maybe you sink your teeth into a cookie. Whatever it is, experience the pleasant taste of something around you.
Now take two deep breaths. (Pause) Open your eyes slowly and take in your surroundings. Let’s take 2 final deep breaths. (Pause) Now give yourself a nice stretch and know that you can return to your happy place any time you like.
After safely putting your goal in the purple balloon (whatever you come up with) push it into the air and let it take its own course, this symbolizes you are letting go of whatever is stressing, frightening, or making you angry or something you want to accomplish.
Many times it can seem to be more stressful to get them to participate, but teens and children can also have their own way of doing things and need a little more prodding. With patience and determination, you can work with your child/teen to help them release their stressors and move on to find more positive things in their lives. Just make it fun and relaxing. Try and look at it from their side. Stay patient and make sure you practice Self-care as well. If you find they still won’t budge, reach out to someone close to you or a professional who specializes in anxiety, trauma, and Cognitive Behavior Therapy.
Wish you the best!
