AKT · Psychiatry/Anxiety & stresslow yield

Acute stress reaction

Overview

A transient, severe reaction to an exceptional physical or psychological stressor, developing within minutes–hours and usually resolving within days (ICD) — by definition within the first month of trauma.

Recognise

Initial "daze", then anxiety, autonomic arousal, dissociation
May show anger, despair, overactivity or withdrawal
Settles within hours to days once the stressor is removed

Red flags

Persistent symptoms beyond 1 month → reassess for PTSD

Differentials & how to tell them apart

PTSDsame symptoms persisting beyond 1 month

Adjustment disorderslower onset, less severe, to a non-catastrophic stressor

Panic disorderrecurrent unexpected attacks without a defining trauma

Investigations

Clinical and time-defined. Distinguish from PTSD by duration (<1 month).

Management

1Reassurance, psychoeducation, practical support and watchful waiting — most resolve spontaneously.
2Active monitoring; if symptoms persist >1 month, manage as PTSD with trauma-focused therapy.

Usually none — short-term hypnotic only if essential; avoid routine drugs

Key points

Do NOT offer single-session debriefing.

Monitor & prognosis

Resolution within days; escalate if persisting.

Usually self-limiting.

Source: ICD-11; NICE NG116