EXPLAINER: What is acute stress disorder and how can it be managed?

She suffered a panic attack when she was ordered to be detained and then transferred from the chamber’s detention facility to the Women’s Correctional Facility in Mandaluyong City by Rep. Joel Chua, chairman of the House Committee on Good Government and Public Accountability, on the night of Nov. 22. In a press conference, she shared she began fearing for her life then as security officers and policemen forcefully entered her cell to serve the transfer order. "This is a threat to my life. It's not harassment," an emotional Lopez said.

She's been admitted to the VMMC since. 

Acute stress disorder and its causes

According to clinical psychologist Lordy Santos a.k.a. Tito Mong Psychologist, acute stress disorder (ASD) is a mental health condition that occurs in response to a traumatic event. It's characterized by intrusive experiences, avoidant behaviors, and intense emotional or physiological arousal.

Unlike typical stress, which can be a temporary reaction to everyday pressures, ASD is an "overwhelming response to an incident that leaves a person feeling helpless, fearful, or out of control." It can result in a variety of emotional, psychological, and physical symptoms, and its onset is often directly linked to specific traumatic triggers.

"Causes would usually include a direct or indirect exposure to actual or threatened death, serious injury, violence, or sexual abuse," Santos told L!fe, adding that ASD can be triggered by internal and external reminders about the traumatic events. 

"Internal triggers may include but is not limited to physical sensations, emotions, thoughts, or thinking patterns that are associated to the experienced traumatic event. External on the other hand, may include people places, sounds-smell or other sensory inputs, and situations that the person associated to the traumatic event," he explained.

Symptoms and diagnosis

Per Santos, symptoms of ASD include intrusive experiences (flashbacks, nightmares, etc.), avoidant behaviors (efforts to avoid associated reminders or events), exaggerated arousal (irritability, sleep disturbances, easily startled, etc.), negative mood (low mood, anxious), and dissociative experiences (traumatic amnesia or altered sense of reality especially about what happened).

"Symptoms would typically appear immediately after exposure to the traumatic event and would last for around one month at most," clinical psychologist Zeia Beatriz Valencia said in an interview with L!fe, adding that the condition can be diagnosed through a combination of clinical interviews, standardized assessments, and observation of symptoms guided by the Diagnostic and Statistical Manual of Mental Disorder-5th Edition, a taxonomic and diagnostic tool published by the American Psychiatric Association.

Santos encouraged the public not to self-diagnose but to immediately seek professional help in case they experience the said symptoms.

Does ASD require prolonged confinement?

Valencia said ASD is "time-limited" and can be resolved within one month after the trauma. It could, however, be considered a "precursor" to Post-Traumatic Stress Disorder (PTSD) if symptoms persist beyond that period.

The mental health disorder can be treated with medications like benzodiazepines and sleeping aids as well as psychotherapeutic procedures such as trauma-focused Cognitive Behavioral Therapy (CBT) or Psychological First-Aid and Eye movement desensitization and reprocessing.

"Other related approaches depend on the preference and condition of the patient, so an integrative approach is always suitable," said Santos. 

Valencia added that stress management and relaxation techniques can also be among the treatment approaches for ASD.

According to the psych expert, ASD does not directly require confinement, though temporary hospitalization might be needed "in cases where the symptoms are severe and they are unable to care for themselves or make safe decisions."

"This is more of a medical decision to help the person recover, not prolonged confinement," she added.

Clinical psychologist Christian Jasper Nicomedes, said that "the earlier the intervention is given, the better." He continued, "The more the individual faces their trauma, the better progress they can have."

While ASD is difficult to prevent since most traumatic events are mostly unpredictable in its development, Santos said that building on a person’s coping capabilities, resilience, and general mental health may lessen one's chances of having it. 

Valencia suggested offering support to someone who needs it. This can be done by "being present, validating their feelings, not pressuring them when they are not yet ready to talk, being mindful of triggers, encouraging them to seek professional help, gently encouraging them to interact with trusted people, and most of all, being patient with them."