Brief overview
- Course of the disease and prognosis: course depends on the extent, recovery without consequences is possible, sometimes transition to longer-lasting disorders, inability to work possible for the duration of the acute phase
- Symptoms: Altered perception, nightmares, flashbacks, memory gaps, sleep disorders, emotional disturbances, physical signs such as palpitations, sweating, trembling
- Therapy: Psychotherapeutic measures, medication
- Causes and risk factors: Threatening traumatic event, e.g. accident, violence, natural disaster
- Examination and diagnosis: Detailed discussion with a psychotherapeutic specialist, sometimes physical examination
- Prevention: There is no general prevention possible. Early therapy often prevents the transition to persistent mental disorders.
What is an acute stress reaction (nervous breakdown)?
Acute stress reaction is colloquially referred to 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 for 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 four weeks after the event)
There are also other reactions that are related to those mentioned:
- Chronic post-traumatic stress disorder: Symptoms persist for three months after the stressful event.
- Adjustment disorder: Due to drastic experiences, such as the loss of a partner, it is no longer possible to cope with everyday life.
It is difficult to say how many people are affected by an acute stress reaction. There is probably a high number of unreported cases. On the one hand, many people are reluctant to seek professional help for mental health problems. On the other hand, the symptoms of an acute stress reaction disappear comparatively quickly.
Are you unable to work with an acute stress reaction?
Whether and for how long you are unable to work with an acute stress reaction depends on the individual case. It is advisable to talk to a doctor about the necessary recovery time after a nervous breakdown. The doctor will assess the person’s ability to cope with stress and will usually issue a certificate of incapacity to work for the required period in the event of an acute stress reaction.
If the acute post-traumatic stress disorder does not subside after three months, a chronic post-traumatic stress disorder develops.
In the event of an acute stress reaction, it is advisable to seek professional help. It relieves those affected and reduces the risk of the symptoms lasting longer. It is also helpful to involve the patient’s environment in order to avoid further, additional stress.
It is important for those affected that relatives are understanding. This includes avoiding accusations, for example if the affected person was involved in the situation, such as in an accident. This is because thoughtless and stressful reactions usually exacerbate the course and symptoms of an acute stress reaction.
What are the symptoms of an acute stress reaction?
An acute stress reaction manifests itself through a variety of symptoms. The following signs and symptoms are typical of a nervous breakdown:
- Altered perception (derealization, depersonalization): The patient perceives the environment or themselves as strange and unfamiliar.
- Narrowing of consciousness: The patient’s thoughts revolve exclusively around a few topics – in this case the stressful situation.
- Re-experiencing the exceptional situation in nightmares or flashbacks
- Gaps in memory
- Avoidance behavior such as social withdrawal
- Emotional disturbances (affect disorder) such as mood swings between aggression (e.g. a nervous breakdown is accompanied by an outburst of anger in some cases), fear and sadness or inappropriate crying and laughing
- Physical symptoms (e.g. blushing, sweating, palpitations, paleness, nausea)
- Speechless horror: The patient cannot put what they have experienced into words and is therefore less able to process it.
Sometimes there are few obvious symptoms before a nervous breakdown occurs. Sometimes there is talk of a “silent nervous breakdown”. However, “silent nervous breakdown” is not a term used by medical professionals.
Some symptoms of a nervous breakdown or acute stress disorder are similar to those of depression, but must be distinguished from them.
The course of a so-called nervous breakdown differs from case to case.
What to do in the event of acute stress disorder?
Many sufferers try to cope with a nervous breakdown on their own. Only some seek help. There are many answers to the question “Nervous breakdown – what to do?”
They help by the very fact that they are able to bring the patient to a safe environment. The patient is then directed to a counselor, psychotherapist or doctor.
Nervous breakdown treatment: first aid
The first step in therapy is to establish contact with the patient. The patient receives support in a safe environment. If the caregiver recognizes a possible risk of suicide during initial discussions with the patient, they will arrange for the patient to be admitted as an inpatient.
If there is no acute danger, treatment is usually provided on an outpatient basis. It consists of various psychological therapies such as
- Behavioral therapy (patients should unlearn a disturbed behavior and learn a new one)
- Psychoeducation (patients should learn to understand the acute stress reaction as an illness and thus cope better)
- EMDR (Eye Movement Desensitization and Reprocessing; certain eye movements are used to re-experience the trauma and process it better)
- Hypnosis
If, for example, the patient is extremely distressed due to sleep disorders, the doctor may prescribe short-term sleep-inducing and sedative medication such as benzodiazepines, Z-substances or sedative antidepressants.
What happens during an acute stress reaction?
Everything that seemed familiar and safe is perceived as dangerous and confused at such times. This includes above all
- bodily harm
- war
- escape
- Sexual violence
- Robberies
- Natural disasters
- Serious accidents
- Terrorist attacks
Acute stress reaction: who is affected?
In principle, everyone is at risk of developing an acute stress reaction. There are various factors that increase the risk of suffering a nervous breakdown. These include, among others:
- Previous illnesses (physical and mental)
- Exhaustion
- Mental vulnerability (vulnerability)
- Lack of strategies to deal with the experience (lack of “coping”)
Examinations and diagnosis
If you suspect an acute stress reaction, a psychiatrist or psychologist is the right person to contact. To find out more about your medical history (anamnesis), they will first interview you in detail. They will ask you the following questions, among others:
- What physical symptoms do you notice?
- How has your condition changed since the event?
- Have you experienced anything similar in the past?
- How did you grow up?
- Do you have any known pre-existing conditions?
The therapist will make sure that you feel safe during the interview.
In addition, he will determine whether you have any risk factors that could promote an acute stress reaction and possibly worsen its course.
Nervous breakdown: test
There are various tests available 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 has the expertise to make the correct diagnosis and at the same time point out and offer treatment options.
How can an acute stress reaction be prevented?
There is no reliable way to prevent a nervous breakdown or an acute stress reaction. Traumatic events happen to people as fate would have it, and it is impossible to predict how those affected will react.
However, if left untreated, the symptoms of an acute stress reaction may persist and develop into other, possibly longer-lasting mental disorders. To prevent this, it is advisable to seek help from a specialist at an early stage after a traumatic experience.
