Difference between Acute Stress Disorder and PTSD

trauma, PTSD, Acute Stress Disorder, Stress, healing from trauma, what is trauma, PTSD treatmentTrauma, Acute Stress Disorder, and PTSD

We all have stress in our lives. After a stressful event, we usually  feel upset for a couple days or weeks  but then go on with our lives with nothing more than a grimace at the memory.  But if something with more impact comes along that overwhelms us, and the distress we feel lasts longer than 2 days, we now have a trauma.

Acute Stress Disorder

The symptoms for Acute Stress Disorder and PTSD are the same. One doesn’t need to have all of them for a diagnosis, only a few from each of the following categories:

  • Re-Experiencing Symptoms: upsetting thoughts or memories, nightmares, flashbacks,  strong responses to reminders of the traumatic event.
  • Avoidance Symptoms: avoiding thoughts, conversations, feelings, places, and people that remind us of the event; loss of interest, feeling distant, difficulty remembering parts of the event.
  • Hyperarousal Symptoms: sleep problems, irritability, outbursts of anger, difficulty concentrating, jumpiness.

According to the DSM-IV, a diagnosis of Acute Stress Disorder requires someone to suffer from the above symptoms for at least 2 days but for less than 4 weeks.


Although the symptoms for Acute Stress Disorder are the same, a diagnosis of PTSD cannot be issued until one has suffered the symptoms for 30 days.  Even if a trauma survivor suffers greatly with severe symptoms following the trauma, they cannot receive a diagnosis or treatment until reaching the 30-day point.

In other words, the difference between Acute Stress Disorder and PTSD is time.

These classifications in the DSM-IV are important because insurance companies and the Veterans Administration adhere to them. Insurance companies won’t pay for treatment nor will the VA administer help for PTSD until the requirements are met—no matter how much the person suffers or how severe the symptoms are.

If you suffer from the above symptoms, don’t wait. Get help now. Contact me and we can talk about it.

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4 Responses to Difference between Acute Stress Disorder and PTSD

  1. Larry, thank you for this information. Now as I know it is so easy to understand that the only difference between Acute Stress Disorder and PTSD is time. Why hasn’t anybody else sold me this piece of information in such an understandable way. Thank you.

    Warm Regards
    Elisabeth Peischl
    Business, Results and Sales Coach.
    Sales Tips, Sales Training, Sales Help for Beginners

  2. Roxi Bennett says:

    I was told in October I was probably suffering from Adjustment disorder. I was told that I’m probably someone that remains calm in an emergency or stressful situation but breaks down once everything is ok. That is very much me. Then they said that I’ve been in a stressful situation for a long time and now that I’m feeling “safe”, it’s hitting me.
    I thought it made sense and have been continuing on my journey of self discovery, self love and self care. But I’m repeating unhealthy behaviors, taking on responsibilities that I don’t need to, spreading myself thin, feeling shame, getting more depressed, less social, I’m tired all the time, I struggle to focus, hyper emotional, crying a lot, a lot…..
    So I started looking into Adjustment disorder. I was told it was a branch of PTSD so I was confused when I saw that “only their symptoms are similar”.
    Your explanation makes sense. Thank you.
    I made a follow up appointment with Mental health today.

  3. Kareen says:

    From what I am learning in my abnormal psychology class, time is not the only difference between the two. It is the main fundamental difference and is important is diagnosis of both ASD and PTSD. ASD has a greater emphasis on dissociative symptoms. “An ASD diagnosis requires that a person experience three symptoms of dissociation (e.g., numbing, reduced awareness, depersonalization, derealization, or amnesia), while the PTSD diagnosis does not include a dissociative symptom cluster. “

    • L. Kessler says:

      There is quite a bit of debate going on about the relationship between ASR, ASD, and PTSD. At the heart of the debate is that a patient can have all the symptoms of ASD continue after the 30 days and still not meet the criteria for PTSD. But after 30 days, ASD is no longer a viable diagnosis. So is ASD a predictor of PTSD? The leaders in the trauma field, Bessel Van der Kolk, Bob Scaer, Peter Levine, etc., have been trying to get the dissociative symptoms of PTSD a more prominent position in the diagnosis. To them, the symptoms of dissociation are the hallmark of PTSD. Perhaps the problem lies in the attempt to reduce the manifestations of ASD and PTSD into artificially restrictive diagnoses. Maybe they’re very much related. Here is a good article that summarizes the issue: http://www.dsm5.org/Research/Documents/ASD%20review%20by%20Bryant%20Published.pdf

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