Acute Stress Disorder in the Elderly

Health Writer

Acute stress disorder (ASD) occurs after a traumatic event of some kind. It can occur when someone either witnessed or experience d an event or situation. Acute stress disorder is characterized by recurring recollections of the event.

One of the more common reasons for acute stress disorder in the elderly is witnessing the death of a friend or loved one. Even when a death is anticipated, such as after a prolonged illness, the actual death can be traumatizing. Many people with ASD will avoid the setting where the death occurred. When this is the hospital, it may be easy to do that. However, if the death took place at home, entering the room can cause recurring memories, not of the person, but of the death itself. Even without the reminders of the place of death, survivors can relive the event over and over.

Symptoms of Acute Stress Disorder

Acute stress disorder is similar to post traumatic stress disorder (PTSD), however, symptoms in acute stress disorder do not last more than 4 weeks. If they last longer, the diagnosis would be changed to PTSD. According to the diagnostic criteria, symptoms must begin within 4 weeks of the event and last at least 2 days, but not more than 4 weeks.

Symptoms of acute stress disorder include:

  • Intrusive and recurring memories of the event
  • Avoidance of the place or situation where the event took place
  • A sense of numbing, detachment or absence of emotional responsiveness
  • A feeling of derealization, depersonalization or amnesia of some or all of the event

Because there is a distinct timetable of symptoms for ASD, it can be quickly diagnosed. This is important in order for the individual to receive proper treatment.

Treatment of Acute Stress Disorder

According to the Merck Manual of Geriatrics, most people recover once they are removed from the situation or place the event took place. Further treatment may include:

  • Allowing the person to describe what happened and their emotional reaction to the event
  • Offering empathy to the individual
  • Medication to help aid sleep

Medications for anxiety are not always needed as other treatments can be quite effective.

One recent study indicted the early use of cognitive behavioral therapy helped to effectively treat ASD as well as prevent post traumatic stress disorder from occurring. This study also indicated that the use of hypnotherapy may be helpful. Recognizing and treating ASD quickly helps to prevent PTSD.

For more information:

Anxiety in the Elderly


"Treating Acute Stress Disorder: An Evaluation of Cognitive Behavior Therapy and Supportive Counseling Techniques, 1999, Bryant et al, The American Journal of Psychiatry, 156:1780,1786, November 1999
"Acute Stress Disorder", Updated 2005, The Merck Manual of Geriatrics, Merck Sharp & Dohme Corp. Whitehouse Station, N.J.