Ngozi Chiekwu , MSN, PMHNP-BC

Integrated Health and Wellness Services, LLC

302-427-8000

1508 Pennsylvania Avenue
 Wilmington, DE 19806

Catastrophic Stress

Everyone is subject to the stresses of everyday life, and most people learn how to cope with them successfully. However, catastrophic stress, also known as acute stress reaction, is an intense reaction to rare, extreme events often involving the threat or exercise of violence, and is difficult to cope with. Catastrophic stress may arise from something personal, such as a sexual assault, or from a public event, such as the September 11, 2001, attack on the World Trade Center. Learning how to cope with catastrophic stress can be difficult. If, for an extended period of time, emotional reactions triggered by the event are getting in the way of relationships, work performance or other important activities, a medical professional should be consulted.

Symptoms of Catastrophic Stress

Reactions to catastrophic stress often appear within minutes of the event, and typically disappear within hours. Symptoms of catastrophic stress may vary and shift over time, and include:

  • Initial daze
  • Narrowing of attention
  • Inability to comprehend stimuli
  • Disorientation

These symptoms may be followed by withdrawal, agitation, panic attack or flight reaction. Partial or complete amnesia of the event may occur.

If symptoms persist for 4 days or more, up to 1 month, a person may be diagnosed as having acute stress disorder. Symptoms of acute stress disorder may include:

  • Crying
  • Agitation
  • Panic
  • Flashbacks
  • Compulsive behavior
  • Hyperawareness
  • Paranoia
  • Numbing or intensifying of emotions

Acute stress disorder can cause significant impairment in social, occupational and other essential functions.

If symptoms persist for longer than 1 month, post-traumatic stress disorder (PTSD) may be diagnosed. PTSD is a long-term condition that is considered more serious than acute stress disorder. Its symptoms may lead to other long-term issues, including depression, alcohol or drug abuse, and suicidal thoughts. These serious symptoms typically require counseling, medication and/or treatment by a mental health professional.

Treatment of Catastrophic Stress

Immediately after a catastrophic event, the affected person should seek help in eliminating traumatic factors. Assuming it is necessary, it should be a priority to move to a safe location and/or to resolve any ongoing concerns about legal consequences (for example, a person involved in a car accident may need legal representation). By addressing immediate concerns arising from the trauma, the person can begin the recovery process.

Treatments may include prolonged exposure therapy and trauma-focused cognitive behavioral therapy, and medication. Beta-blocker medications can help to block stress hormones and relieve physical symptoms. Diazepam, a tranquillizer, may be prescribed, although only for a short period because it is addictive, and loses its effect after a few days.

Additional Resources