Acute stress reaction

and Eva Rudolf-Müller, doctor

Mareike Müller is a freelance writer in the medical department and assistant doctor for neurosurgery in Düsseldorf. She studied human medicine in Magdeburg and gained a lot of practical medical experience during her stays abroad on four different continents.

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Eva Rudolf-Müller is a freelance writer in the medical team. She studied human medicine and newspaper sciences and has repeatedly worked in both areas - as a doctor in the clinic, as a reviewer, and as a medical journalist for various specialist journals. She is currently working in online journalism, where a wide range of medicine is offered to everyone.

More about the experts All content is checked by medical journalists.

An acute stress reaction, also known colloquially as a nervous breakdown, is triggered by a traumatic event. The patients suffer, for example, from memory gaps, nightmares or palpitations. If the symptoms last longer than two days, one speaks of an acute stress disorder. Those affected can be helped with psychotherapeutic support or medication. Read everything about the acute stress reaction here.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. F43

Acute stress reaction: description

Colloquially, the acute stress reaction is also known as a nervous breakdown. It is a temporary, extreme reaction to a stressful event. It is one of the possible psychological reactions to a traumatic experience. Depending on the length of time in which the symptoms persist, a distinction is made between the following forms:

• Acute stress reaction (up to 48 hours after the event)
• Acute stress disorder (up to 4 weeks after the event)
• Acute post-traumatic stress disorder (up to 3 months after the event)

Other reactions related to the above are:

• Chronic post-traumatic stress disorder: Symptoms persist even 3 months after the stressful event.
• Adjustment disorder: Due to drastic experiences, such as the loss of a partner, everyday life can no longer be coped with.

It is difficult to say how many people in Germany are restricted each year by an acute stress reaction. It is assumed that there is a high number of unreported cases, as many patients shy away from going to the doctor with psychological problems and do not always seek professional help. This is especially true when, as with the acute stress reaction, the symptoms disappear comparatively quickly on their own.

Acute stress reaction: symptoms

An acute stress reaction manifests itself through a variety of symptoms. Symptoms typical of a nervous breakdown can include:

• Changed perception (derealization, depersonalization): The patient perceives the environment or himself as strange and unknown.
• Narrowing of consciousness: The patient's thoughts revolve around a few topics - in this case the stressful situation.
• Reliving the exceptional situation in nightmares or flashbacks
• Gaps in memory
• Overexcitation in the sense of sleep disorders, poor concentration, frightfulness, increased irritability
• Avoidance behavior such as social withdrawal
• Emotional disorders (affect disorder) such as mood swings between aggression, fear and sadness or inappropriate crying and laughing
• Physical symptoms (e.g., flushing, sweating, racing heart, paleness, nausea)
• Speechless horror: The patient cannot put what he has experienced into words and can therefore process it more poorly.

Acute stress reaction: causes and risk factors

The reason for an acute stress reaction is a traumatic experience. It does not matter whether something terrible has happened to you or whether you are an observer, relative or helper in the situation. The event is often life-threatening and is able to turn the world upside down for the person concerned. Everything that seemed familiar and safe is perceived as dangerous and confused at such moments. Above all, these include:

• Bodily harm
• war
• escape
• Sexual violence
• Robberies
• Natural disasters
• Serious accidents
• terrorist attacks

Acute stress reaction: who is affected?

In principle, anyone can develop an acute stress reaction. There are several factors that increase your risk of having a nervous breakdown. These include:

• Previous illnesses (physical and mental)
• exhaustion
• Mental vulnerability (vulnerability)
• Lack of strategies to deal with the experience (lack of coping)

Acute stress reaction: examinations and diagnosis

If you are suspected of having an acute stress reaction, you will be examined by a psychiatrist or psychologist. To find out more about your medical history (anamnesis), he will first ask you in detail. He asks you, among other things, the following possible questions:

• What physical symptoms do you experience?
• How has your condition changed since the event?
• Have you experienced something similar in the past?
• How did you grow up?
• Do you have any previous illnesses?

The doctor or therapist will make sure that you feel safe during the conversation. He also examines you physically to determine various parameters such as heart rate, blood pressure and breathing rate. In this way, he can tell if your body is reacting to what has happened with symptoms. He will also try to find out whether you have any risk factors that could promote an acute stress reaction and worsen the course.

Nervous breakdown: test

Various tests are circulating on the Internet to test yourself for an acute stress reaction. In an exceptional situation, it is better to seek advice from a specialist who can make the correct diagnosis and at the same time point out and offer therapy options.

Acute stress reaction: treatment

Many sufferers try to cope with a nervous breakdown on their own. Help is only available to a few. There are many answers to the question “Nervous breakdown - what to do?”. In the acute emergency situation, there are different groups of people who are trained to help someone with an acute stress reaction. Above all, this includes people who are the first to come to the site of a terrible event: police officers, firefighters, soldiers, members of the THW or paramedics. They help by the fact that they are able to get the patient into a safe environment. In the further course the patient can be referred to a pastor, psychotherapist or doctor.

Nervous Breakdown Treatment: Procedure

In the first step of therapy, the focus is on establishing contact with the patient. Support is offered to him in a safe environment. If a possible risk of suicide (suicidality) is identified in the first discussions with the patient, the patient is usually admitted to the hospital. If there is no sign of suicidality, treatment can usually be carried out on an outpatient basis. It consists of various psychological therapies such as:

• Behavioral therapy (patients should unlearn a disordered behavior and learn a new one)
• Psychoeducation (patients should learn to understand the acute stress reaction as a disease and thus better cope with it)
• EMDR (Eye Movement Desensitization and Reprocessing; through certain eye movements, the trauma should be experienced anew and better processed)
• hypnosis

For example, if the patient is extremely stressed by sleep disorders, short-term sleep-inducing and depressant drugs such as benzodiazepines, Z-substances or sedating antidepressants can be prescribed.

Acute stress reaction: course and prognosis

According to the definition, the acute stress reaction lasts up to 48 hours after a stressful event. It can then heal without consequences. It is also possible that it turns into the longer-lasting acute stress disorder, which in turn can become an acute post-traumatic stress reaction. This can subside after three months or turn into a chronic post-traumatic stress disorder.

In the event of an acute stress reaction, it is advisable to seek professional help. This relieves the person concerned and reduces the risk that the symptoms will last longer. In addition, the patient's environment should be made aware of the importance of avoiding further stress. Above all, the relatives should treat the person concerned with understanding and avoid blaming them if they were involved in the situation, for example in an accident. After all, clumsy and stressful reactions can worsen the symptoms of nervous breakdown of the acute stress reaction.

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