Reactions to severe stress are currently (according to ICD-10) divided into the following:

Acute reactions to stress;

Post-traumatic stress disorders;

Adaptation disorders;

Dissociative disorders.

Acute reaction to stress

A transient disorder of significant severity that develops in individuals without apparent mental disorder in response to exceptional physical and psychological stress and that usually resolves within hours or days. Stress may be a severe traumatic experience, including a threat to the safety or physical integrity of the individual or loved one (eg, natural disaster, accident, battle, criminal behavior, rape) or an unusually abrupt and threatening change in the social status and/or environment of the sufferer, e.g. the loss of many loved ones or a fire in the house. The risk of developing the disorder increases with physical exhaustion or the presence of organic factors (for example, in elderly patients).

Individual vulnerability and adaptive capacity play a role in the occurrence and severity of acute stress reactions; This is evidenced by the fact that not all people exposed to severe stress develop this disorder.

Symptoms show a typical mixed and fluctuating pattern and include an initial state of "stupefaction" with some narrowing of the field of consciousness and decreased attention, inability to respond adequately to external stimuli, and disorientation. This state may be accompanied by either further withdrawal from the surrounding situation up to the point of dissociative stupor, or by agitation and hyperactivity (flight or fugue reaction).

Autonomic signs of panic anxiety (tachycardia, sweating, flushing) are often present. Symptoms usually develop within minutes of exposure to a stressful stimulus or event and disappear within two to three days (often hours). Partial or complete dissociative amnesia may be present.

Acute reactions to stress occur in patients immediately after traumatic exposure. They are short-lived, from several hours to 2-3 days. Autonomic disorders, as a rule, are of a mixed nature: there is an increase in heart rate and blood pressure and, along with this, pale skin and profuse sweat. Motor disturbances are manifested either by sudden agitation (throwing) or retardation. Among them, the affective-shock reactions described at the beginning of the 20th century are observed: hyperkinetic and hypokinetic. With the hyperkinetic variant, patients rush around non-stop and make chaotic, unfocused movements. They do not respond to questions, much less the persuasion of others, and their orientation in their surroundings is clearly disturbed. With the hypokinetic variant, patients are sharply inhibited, they do not react to their surroundings, do not answer questions, and are stunned. It is believed that in the origin of acute reactions to stress, not only a powerful negative impact plays a role, but also the personal characteristics of the victims - old age or adolescence, weakness of any somatic disease, such character traits as increased sensitivity and vulnerability.

In ICD-10 the concept post-traumatic stress disorder combines disorders that do not develop immediately after exposure to a psychotraumatic factor (delayed) and last for weeks, and in some cases for several months. These include: the periodic appearance of acute fear (panic attacks), severe sleep disturbances, obsessive memories of a traumatic event that the victim cannot get rid of, persistent avoidance of places and people associated with the traumatic factor. This also includes long-term persistence of a gloomy and melancholy mood (but not to the level of depression) or apathy and emotional insensitivity. Often people in this state avoid communication (run wild).

Post-traumatic stress disorder is a non-psychotic delayed response to traumatic stress that can cause mental health problems in almost anyone.

Historical research in the field of PTSD has developed independently of stress research. Despite some attempts to build theoretical bridges between “stress” and post-traumatic stress, the two areas still have little in common.

Some of the famous stress researchers, such as Lazarus, who are followers of G. Selye, largely ignore PTSD, like other disorders, as possible consequences stress, limiting the field of attention to studies of the characteristics of emotional stress.

Stress research is experimental in nature, using special experimental designs under controlled conditions. Research on PTSD, in contrast, is naturalistic, retrospective, and largely observational.

Criteria for post-traumatic stress disorder (according to ICD-10):

1. The patient must be exposed to a stressful event or situation (both short-term and long-term) of an exceptionally threatening or catastrophic nature, which can cause distress.

2. Persistent memories or “reliving” of the stressor in intrusive flashbacks, vivid memories and recurring dreams, or re-experiencing grief when exposed to situations reminiscent of or associated with the stressor.

3. The patient must demonstrate actual avoidance or a desire to avoid circumstances reminiscent of or associated with the stressor.

4. Either of the two:

4.1. Psychogenic amnesia, either partial or complete, regarding important periods of exposure to a stressor.

4.2. Persistent symptoms of increased psychological sensitivity or excitability (not observed before the stressor), represented by any two of the following:

4.2.1. difficulty falling or staying asleep;

4.2.2. irritability or angry outbursts;

4.2.3. difficulty concentrating;

4.2.4. increased level of wakefulness;

4.2.5. enhanced quadrigeminal reflex.

Criteria 2,3,4 occur within 6 months after a stressful situation or at the end of a period of stress.

Clinical symptoms of PTSD (according to B. Kolodzin)

1. Unmotivated vigilance.

2. “Explosive” reaction.

3. Dullness of emotions.

4. Aggressiveness.

5. Impaired memory and concentration.

6. Depression.

7. General anxiety.

8. Attacks of rage.

9. Abuse of narcotic and medicinal substances.

10. Unbidden memories.

11. Hallucinatory experiences.

12. Insomnia.

13. Thoughts about suicide.

14. “Survivor Guilt.”

Speaking, in particular, about adaptation disorders, one cannot help but dwell in more detail on such concepts as depression and anxiety. After all, they are the ones that always accompany stress.

Previously dissociative disorders were described as hysterical psychoses. It is understood that in this case the experience of a traumatic situation is displaced from consciousness, but is transformed into other symptoms. The appearance of very pronounced psychotic symptoms and the loss of sound in the experiences of the suffered psychological impact of a negative plan mark dissociation. This same group of experiences includes conditions previously described as hysterical paralysis, hysterical blindness, and deafness.

The secondary benefit for patients of the manifestations of dissociative disorders is emphasized, that is, they also arise through the mechanism of escape into illness, when psychotraumatic circumstances are unbearable and super-strong for the fragile nervous system. A common feature of dissociative disorders is their tendency to recur.

The following forms of dissociative disorders are distinguished:

1. Dissociative amnesia. The patient forgets about the traumatic situation, avoids places and people associated with it; reminders of the traumatic situation meet with fierce resistance.

2. Dissociative stupor, often accompanied by loss of pain sensitivity.

3. Puerilism. Patients respond to psychotrauma with childish behavior.

4. Pseudo-dementia. This disorder occurs against the background of mild stunning. Patients are confused, look around in bewilderment and display the behavior of the weak-minded and incomprehensible.

5. Ganser syndrome. This condition resembles the previous one, but includes passing speech, that is, patients do not answer the question (“What is your name?” - “Far from here”). It is impossible not to mention neurotic disorders associated with stress. They are always acquired, and not constantly observed with childhood and until old age. In the origin of neuroses, purely psychological causes (overwork, emotional stress) are important, and not organic influences on the brain. Consciousness and self-awareness are not impaired in neuroses; the patient is aware that he is sick. Finally, with adequate treatment, neuroses are always reversible.

Adjustment disorder observed during the period of adaptation to a significant change in social status (loss of loved ones or long-term separation from them, refugee status) or to a stressful life event (including a serious physical illness). In this case, a temporary connection between stress and the resulting disorder must be proven - not more than 3 months from the onset of the stressor.

At adjustment disorders in the clinical picture the following are observed:

depressed mood

• anxiety

  feeling of inability to cope with the situation or adapt to it

  some decrease in productivity in daily activities

  tendency towards dramatic behavior

  outbursts of aggression.

Based on their predominant characteristics, the following are distinguished: adjustment disorders:

short-term depressive reaction (no more than 1 month)

prolonged depressive reaction (no more than 2 years)

mixed anxious and depressive reaction, with a predominance of disturbance of other emotions

reaction with a predominance of behavioral disturbances.

Among other reactions to severe stress, nosogenic reactions are also noted (develop in connection with a severe somatic illness). There are also acute reactions to stress, which develop as reactions to an exceptionally strong, but short-lived (over hours, days) traumatic event that threatens the mental or physical integrity of the individual.

Affect is usually understood as a short-term strong emotional disturbance, which is accompanied not only by an emotional reaction, but also by the excitement of all mental activity.

Highlight physiological affect, for example, anger or joy, not accompanied by confusion, automatisms and amnesia. Asthenic affect- quickly depleted affect, accompanied by depressed mood, decreased mental activity, well-being and vitality.

Thenic affect characterized by increased well-being, mental activity, and a sense of personal strength.

Pathological affect- a short-term mental disorder that occurs in response to intense, sudden mental trauma and is expressed in the concentration of consciousness on traumatic experiences, followed by an affective discharge, followed by general relaxation, indifference and often deep sleep; characterized by partial or complete amnesia.

In some cases, pathological affect is preceded by a long-term psychotraumatic situation and the pathological affect itself arises as a reaction to some kind of “last straw”.

A transient disorder of significant severity that develops in individuals without apparent mental disorder in response to exceptional physical and psychological stress and that usually resolves within hours or days. Stress may be a severe traumatic experience, including a threat to the safety or physical integrity of the individual or loved one (eg, natural disaster, accident, battle, criminal behavior, rape) or an unusually abrupt and threatening change in the social status and/or environment of the sufferer, e.g. the loss of many loved ones or a fire in the house. The risk of developing the disorder increases with physical exhaustion or the presence of organic factors (for example, in elderly patients).

Individual vulnerability and adaptive capacity play a role in the occurrence and severity of acute stress reactions; This is evidenced by the fact that not all people exposed to severe stress develop this disorder. Symptoms show a typical mixed and fluctuating pattern and include an initial state of “dazedness” with some narrowing of the field of consciousness and decreased attention, inability to respond adequately to external stimuli and disorientation. This state may be accompanied by either further withdrawal from the surrounding situation (up to dissociative stupor - F44.2), or agitation and hyperactivity (flight or fugue reaction). Autonomic signs of panic anxiety (tachycardia, sweating, flushing) are often present. Symptoms usually develop within minutes of exposure to a stressful stimulus or event and disappear within two to three days (often hours). Partial or complete dissociative amnesia (F44.0) of the episode may be present. If symptoms persist, then the question arises of changing the diagnosis (and management of the patient).

Diagnostic instructions:

There must be a clear and clear temporal relationship between exposure to the unusual stressor and the onset of symptoms; It usually pumped immediately or within a few minutes. In addition, symptoms:

a) have a mixed and usually changing picture; in addition to the initial state of stupor, depression, anxiety, anger, despair, hyperactivity and withdrawal may be observed, but none of the symptoms predominates for a long time;

b) stop quickly (within a few hours at most) in cases where it is possible to eliminate the stressful situation. In cases where stress continues or by its nature cannot stop, symptoms usually begin to disappear after 24-48 hours and are minimized within 3 days.

This diagnosis cannot be used to refer to sudden exacerbations of symptoms in persons already having symptoms that meet the criteria for any mental disorder except those in F60.- (specific personality disorders). However, a previous history of mental disorder does not make the use of this diagnosis inappropriate.

Included:

Nervous demobilization;

Crisis state;

Acute crisis response;

Acute reaction to stress;

Combat fatigue;

Mental shock.

ACUTE REACTION TO STRESS (ICD 308)

very rapidly transient disorders of varying severity and nature, which are observed in persons without any obvious mental disorder in the past, in response to an exceptional physical or mental situation (for example, a natural disaster or fighting) and which usually disappear after a few hours or days. An acute stress reaction may be a manifestation of a preexisting emotional disorder (eg, panic, agitation, fear, depression, or anxiety), a disorder of consciousness (eg, ambulatory automatism), or a psychomotor disorder (eg, agitation or stupor). Synonyms: catastrophic stress reaction; delirium in a state of exhaustion (not recommended); emotional reaction to the horrors suffered during combat operations; post-traumatic stress disorder.

The reaction to stress is acute

Thus, according to ICD-10 (F43.0.), clinical manifestations of a neurotic reaction are designated if its characteristic symptoms persist for a short period - from several hours to 3 days. In this case, stupor, some narrowing of the field of consciousness, decreased attention, inability to adequately respond to external stimuli, and disorientation are possible. Partial or complete amnesia of the stress factor is possible.

Acute reaction to stress

a transient and short-term (hours, days) psychotic disorder that occurs in response to exceptional physical and/or psychological stress with an obvious threat to life in persons without a pre-existing mental disorder. Examples of such stress: a natural or man-made disaster, participation in a bloody military operation, a terrorist attack with many casualties, an accident with extremely tragic consequences, rape, especially group and infinitely cruel; loss of children; etc. Individual sensitivity to stress is very variable: what for one person is another serious test, for another can become a severe, unbearable mental trauma. The risk of developing this disorder increases significantly with physical exhaustion, in old age, in the presence of cerebral-organic factors, constitutional predisposition (reactive lability), the complete surprise of what happened, mass casualties, the absence of signs of adequate assistance to victims from outside, and a lack of positive experience of stress tests. The disorder develops acutely, within a few minutes, tens of minutes from the moment of realizing the fact that something indescribably terrible and unimaginable has happened. If the symptoms of an acute reactive psychotic state persist for more than 2-3 days, then its cause is not only or even not so much stress, but, most likely, something else.

The symptom complex of the disorder includes the following main features: 1. confusion with an incomplete, fragmented perception of the situation, often focusing attention on its random, side aspects and, in general, a lack of understanding of the essence of what is happening, which leads to a deficit in the perception of information, the inability to structure it for the organization of purposeful, adequate actions . Productive psychopathological symptoms (delusions, hallucinations, etc.) apparently do not exist or, if they occur, they are abortive, rudimentary in nature; 2. insufficient contact with patients, poor understanding of questions, requests, instructions; 3. psychomotor and speech retardation, reaching in some patients the degree of dissociative (psychogenic) stupor with freezing in one position or, on the contrary, which is less common, motor and speech agitation with fussiness, confusion, confused, inconsistent verbosity, sometimes verbalizations of despair; in a relatively small proportion of patients, disordered and intense motor agitation occurs, usually in the form of panicked flight and impulsive actions that are carried out contrary to the demands of the situation and are fraught with serious consequences, including death; 4. severe autonomic disorders (mydriasis, pallor or hyperemia of the skin, vomiting, diarrhea, hyperhidrosis, symptoms of cerebral and cardiac circulatory failure, which causes some patients to die, etc.) and 5. subsequent complete or partial congrade amnesia. There may also be confusion, despair, a feeling of the unreality of what is happening, isolation, mutism, and unmotivated aggressiveness. The clinical picture of the disorder is polymorphic, changeable, and often mixed. In premorbid psychiatric patients, the acute reaction to stress may be somewhat different and not always typical, although information about the characteristics of the response of patients with various mental disorders to severe stress (depression, schizophrenia, etc.) seems insufficient. As a rule, the source of more or less reliable information about severe forms of the disorder is one of the strangers; they, in particular, can be rescuers.

After the end of the acute reaction to stress, most patients reveal, as Z.I. Kekelidze (2009) points out, symptoms of the transition period of the disorder (affective tension, sleep disturbances, psycho-vegetative disorders, behavioral disorders, etc.) or a period of post-traumatic stress disorder (PTSD) begins ). An acute reaction to stress occurs in approximately 1-3% of disaster victims. The term is not entirely accurate - stress itself is considered to be psychotraumatic situations in relation to which a person retains the confidence or hope that mobilizes him to overcome them. Treatment: placement in a safe environment, tranquilizers, antipsychotics, anti-shock measures, psychotherapy, psychological correction. Synonyms: Crisis state, Acute crisis reaction, Battle fatigue, Mental shock, Acute reactive psychosis.

Acute reaction to stress is a category of severe, reversible, short-term mental disorders. This disorder occurs as a result of a response to strong psychological or social stressors - combat, earthquakes, disasters, the sudden death of a loved one.

Types of acute reactions to stress

The impact of a psychotraumatic factor can have different courses and characteristics. Subject to availability distinctive features mental disorder is divided into the following types:

• depressive - manifested by a constant depressed mood, hopelessness, and a feeling of fear;
• anxious - characterized by tremor, rapid heartbeat, excitement, and excited state;
• emotionally mixed - the simultaneous presence of several signs, including anxiety and depressive symptoms;
• violation of the behavioral component - occurs with a change in behavior, violation of public moral norms;
• disturbances in the sphere of study or work - accompanied by a lack of interest in everyday activities, a depressive and anxious state that disappears when changing occupations.

Causes and symptoms of acute stress response

An acute stress reaction is formed during a strong experience that traumatizes the human psyche. This category of situations includes an accident, an accident, the death of a loved one, rape, a disaster, a sharp change in the situation in society, and criminal acts. During stress, a fixation occurs on mental defense mechanisms - repression, extreme identification. As a result of the action of these mechanisms, changes in consciousness, disturbances in perception and behavior occur.

The severity and severity of mental disorder depends on the individual characteristics and adaptive abilities of the individual. Evidence of this is the fact that not all people who experience a severely stressful situation develop an acute disorder.

The symptomatic picture has mixed and changing signs. First stage the formation of an acute reaction is characterized by a state of stupor, accompanied by:

• attention deficit disorder;
• narrowing of consciousness;
• inability to adequately respond to environmental stimuli;
• disorientation.

This condition can occur with further withdrawal from the traumatic situation or hyperactivity and excessive anxiety. Some people experience complete or partial forgetting of the episode that caused the development of post-traumatic stress. Most patients experience autonomic changes in the form of excessive sweating, tachycardia, and redness of the skin.

Symptomatic manifestations of adaptation disorder occur within a few minutes from the moment of exposure to the traumatic factor and in most cases are eliminated after 2-3 hours. The risk of developing an acute disorder increases in people with weak nervous system, physically exhausted, elderly.

Treating Acute Stress Reactions

Before starting treatment for a mental disorder, a person must go through a diagnostic stage. Patients are examined only in a clinical setting. Psychologists take into account the nature of the crisis state and the strength of the impact of the event. Experts carry out research human body in order to identify mental and somatic pathologies.

Psychiatric diagnosis allows us to exclude post-traumatic syndrome, depression, and anxiety disorder. A comprehensive examination allows you to establish a diagnosis and choose the necessary treatment strategy.

Correction of adaptation disorders, adaptation period, acute reactions is carried out in stages. The individual nature of complex treatment depends on the severity of symptoms and the personal characteristics of the patient.

The main correction method mental illness is psychotherapy. This method is predominant due to its pronounced psychological component. Therapeutic intervention is aimed at strengthening the control of negative emotions. In the course of work, the patient’s attitude towards a traumatic situation changes, and a behavioral model of responding to stress is created.

In some cases, patients require maintenance drug therapy, including the following drugs:

• antidepressants;
• sedatives;
• sleeping pills.

Therapy medicines based on the recommendations of the treating doctor. Full therapeutic effects and regular visits to consultations with a psychotherapist allow you to return to a normal lifestyle.

A transient disorder of significant severity that develops in individuals without apparent mental disorder in response to exceptional physical and psychological stress and that usually resolves within hours or days. Stress can be a serious injury -

tic experience, including a threat to the safety or physical integrity of the individual or loved one (eg, natural disaster, accident, battle, criminal behavior, rape) or an unusually abrupt and threatening change in the social status and/or environment of the patient, such as the loss of many loved ones or fire in the house. The risk of developing the disorder increases with physical exhaustion or the presence of organic factors (for example, in elderly patients).

Individual vulnerability and adaptive capacity play a role in the occurrence and severity of acute stress reactions; This is evidenced by the fact that not all people exposed to severe stress develop this disorder. Symptoms show a typical mixed and fluctuating pattern and include an initial state of “dazedness” with some narrowing of the field of consciousness and decreased attention, inability to respond adequately to external stimuli and disorientation. This state may be accompanied by either further withdrawal from the surrounding situation (up to dissociative stupor - F44.2), or agitation and hyperactivity (flight or fugue reaction). Autonomic signs of panic anxiety (tachycardia, sweating, flushing) are often present. Symptoms usually develop within minutes of exposure to a stressful stimulus or event and disappear within two to three days (often hours). Partial or complete dissociative amnesia (F44.0) of the episode may be present. If symptoms persist, then the question arises of changing the diagnosis (and management of the patient).

Diagnostic instructions:

There must be a clear and clear temporal relationship between exposure to the unusual stressor and the onset of symptoms; It usually pumped immediately or within a few minutes. In addition, symptoms:

a) have a mixed and usually changing picture; in addition to the initial state of stupor, depression, anxiety, anger, despair, hyperactivity and withdrawal may be observed, but none of the symptoms predominates for a long time;

b) stop quickly (within a few hours at most) in cases where it is possible to eliminate the stressful situation;

new items In cases where stress continues or by its nature cannot stop, symptoms usually begin to disappear after 24-48 hours and are minimized within 3 days.

This diagnosis cannot be used to refer to sudden exacerbations of symptoms in persons already having symptoms that meet the criteria for any mental disorder except those in F60.- (specific personality disorders). However, a previous history of mental disorder does not make the use of this diagnosis inappropriate.

Included:

Nervous demobilization;

Crisis state;

Acute crisis response;

Acute reaction to stress;

Combat fatigue;

Mental shock.

F43.1 Post-traumatic stress disorder

Occurs as a delayed and/or protracted response to a stressful event or situation (short-term or long-term) of an exceptionally threatening or catastrophic nature, which in principle can cause general distress in almost any person (for example, natural or man-made disasters, battles, serious accidents, surveillance for the violent death of others, being a victim of torture, terrorism, rape or other crime). Predisposing factors, such as personality traits (for example, compulsive, asthenic) or a previous neurotic disease may lower the threshold for the development of this syndrome or aggravate its course, but they are not necessary and insufficient to explain its occurrence.

Typical signs include episodes of re-experiencing the trauma in the form of intrusive memories (reminiscences), dreams or nightmares, occurring against a background of chronic feelings of “numbness” and emotional distress.

mental dullness, withdrawal from other people, lack of response to the environment, anhedonia, and avoidance of activities and situations that are reminiscent of the trauma. Typically, the individual fears and avoids what reminds him of the original trauma. Rarely, there are dramatic, acute outbursts of fear, panic, or aggression, triggered by stimuli that evoke an unexpected memory of the trauma or the original reaction to it.

Usually there is a state of increased autonomic excitability with increased levels of wakefulness, increased fear response and insomnia.

The above symptoms and signs are usually accompanied by anxiety and depression, suicidal ideation is common, and excessive alcohol or drug use may be a complicating factor.

The onset of this disorder occurs following trauma after a latent period that can vary from several weeks to months (but rarely more than 6 months). The course is undulating, but in most cases recovery can be expected. In a small proportion of cases, the condition may show a chronic course over many years and transition to a persistent personality change after experiencing a catastrophe (F62.0).

Diagnostic instructions:

This disorder should not be diagnosed unless there is evidence that it began within 6 months of a severe traumatic event. A “presumptive” diagnosis is possible if the interval between event and onset is more than 6 months, but the clinical presentation is typical and there is no possibility of an alternative classification of the disorder (eg, anxiety or obsessive-compulsive disorder or depressive episode). Evidence of trauma must be supplemented by recurrent intrusive memories of the event, daytime fantasies, and imaginings. Marked emotional withdrawal, numbing of feelings, and avoidance of stimuli that might trigger memories of the trauma are common but not necessary for diagnosis. Autonomic disorders

disorders, mood disorders and behavioral disorders may include

into the diagnosis, but are not of primary importance.

Long-term chronic effects of debilitating stress, that is, those that manifest themselves decades after the stress exposure, should be classified in F62.0.

Included:

Traumatic neurosis.

What is Acute Stress Reaction?

Acute reaction to stress A transient disorder of significant severity that develops in individuals without apparent mental disorder in response to exceptional physical and psychological stress and that usually resolves within hours or days. Stress may be a severe traumatic experience, including a threat to the safety or physical integrity of the individual or loved one (eg, natural disaster, accident, battle, criminal behavior, rape) or an unusually abrupt and threatening change in the social status and/or environment of the sufferer, e.g. the loss of many loved ones or a fire in the house. The risk of developing the disorder increases with physical exhaustion or the presence of organic factors (for example, in elderly patients).

What Causes Acute Stress Reaction?

SA;">Occurs during a strong traumatic experience (natural disaster, accident, rape, loss of loved ones). At the moment of stress, fixation on such defense mechanisms as extreme identification, repression occurs. As a result, changes in consciousness, disturbances in perception and behavior are possible.

Symptoms of Acute Stress Reaction

Individual vulnerability and adaptive capacity play a role in the occurrence and severity of acute stress reactions; This is evidenced by the fact that not all people exposed to severe stress develop this disorder. Symptoms show a typical mixed and fluctuating pattern and include an initial state of “dazedness” with some narrowing of the field of consciousness and decreased attention, inability to respond adequately to external stimuli and disorientation. This state may be accompanied by either further withdrawal from the surrounding situation (up to dissociative stupor), or agitation and hyperactivity (flight or fugue reaction). Partial or complete dissociative amnesia of the episode may be present. Autonomic signs of panic anxiety (tachycardia, sweating, flushing) are often present. Symptoms usually develop within minutes of exposure to a stressful stimulus or event and disappear within two to three days (often hours). The risk of developing the disease increases with physical exhaustion or in the elderly. After the loss of loved ones as a result of earthquakes, there is a conviction that the dead are actually alive, flight from the site of the tragedy, behavior with infantile traits (puerilism), freezing at the site of the tragedy and refusal to leave it. Similar reactions occur with the sudden death of a loved one.

Diagnosis of Acute Stress Reaction

To make a diagnosis, there must be a clear and clear temporal relationship between exposure to the unusual stressor and the onset of symptoms; onset is usually immediate or within a few minutes. In addition, symptoms:

• have a mixed and usually changing picture; in addition to the initial state of stupor, depression, anxiety, anger, despair, hyperactivity and withdrawal may be observed, but none of the symptoms predominates for a long time;
• stop quickly (within a few hours at most) in cases where it is possible to eliminate the stressful situation. In cases where stress continues or by its nature cannot stop, symptoms usually begin to disappear after 24-48 hours and are minimized within 3 days.

If symptoms persist, then the question arises of changing the diagnosis (and management of the patient).

This diagnosis cannot be used to refer to sudden exacerbation of symptoms in individuals already presenting with symptoms that meet the criteria for any mental disorder other than specific personality disorders. However, a previous history of mental disorder does not make the use of this diagnosis inappropriate.

Treatment of Acute Stress Reaction

SA;">Tranquilizers, such as diazepam up to 20 mg, antidepressants, sleep therapy, gestalt therapy, group and family therapy.

Which doctors should you contact if you have an acute reaction to stress?

Psychiatrist

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